Choosing a Metal Plan through the Marketplace Exchanges

The metal health plan categories available through the Marketplace Exchanges determine how you and your plan share costs of care. Each plan contributes a different percentage of the patient’s total cost of care. Things like premiums, deductibles, copays, coinsurance and out of pocket maximums all affect the category you should consider for you and your family.

  • Consider your and your family’s healthcare needs when determining what metal plan works best for you.
  • If you will frequently visit a doctor or need regular prescriptions, the Platinum and Gold Plans might be a good fit for you.
  • If you don’t expect as many doctor visits and don’t take regular prescriptions, consider looking into a Bronze or Silver plan.
  • For the bare minimum coverage, the Catastrophic Plan is an option for those that qualify.
  • You can save on your out of pocket costs based on your household size, with the Silver plan offering the best value.
  • The higher your monthly premium, the more your insurance will pay for your cost of care.
Metal Plan Insurance Pays You Pay
Platinum 90% of your medical costs 10% of your medical costs
Gold 80% of your medical costs 20% of your medical costs
Silver 70% of your medical costs 30% of your medical costs
Bronze 60% of your medical costs 40% of your medical costs
Catastrophic

(must qualify)

Less than 60% of your medical costs More than 50% of your medical costs

Additional tips:

  • Search plans in your area here.
  • If you’re having trouble deciding what plan works best for you, plan navigators are available by phone here.
  • Find out if you’re eligible for tax breaks here.

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