Bronze, Silver and Gold Obamacare plans: the differences and which one fits you

What each level means

According to HealthCare.gov, this is what the plan pays, on average, for covered services:

• Bronze: the plan pays about 60% and you pay 40%. The deductible is generally high.
• Silver: the plan pays about 70% and you pay 30%. The deductible is generally moderate.
• Silver with extra savings: the plan pays 73% to 94%, depending on the savings you qualify for. The deductible is generally low.
• Gold: the plan pays about 80% and you pay 20%. The deductible is generally low.
• Platinum: the plan pays about 90% and you pay 10%. The deductible is generally low.

These are plan averages, not what you will pay at each visit. And according to HealthCare.gov, the levels have nothing to do with the quality of care you receive.

Extra savings: only with a Silver plan

If your income is within the range for extra savings (cost-sharing reductions), HealthCare.gov is clear: you only get them if you choose a Silver plan. Those savings lower your deductible, copayments and out-of-pocket maximum, and the lower your income within the range, the more you save.

That is why, if you qualify, a Silver plan may be a better deal than a Bronze plan even if the monthly premium is a little higher.

How to choose your level

A simple way to think about it:

• Bronze: if you rarely see a doctor and want the lowest premium, knowing that if you get sick you will pay more before the plan starts paying.
• Silver: if you qualify for extra savings, or if you want a middle ground between premium and deductible.
• Gold or Platinum: if you see doctors often, take expensive medications or expect treatment, and prefer to pay more each month and less when you use your insurance.

Before you choose, check that your doctors, your hospital and your medications are in the plan’s network. That matters as much as the level.

Government help and the level you choose

According to the IRS, the help with your premium is calculated with the price of the second-lowest-cost Silver plan in your area, but you can use it on any level. It can never be more than your plan’s premium: that is why, with the same help, a Bronze plan may cost less per month and a Gold plan more.

What about catastrophic plans?

According to HealthCare.gov, they are a fifth category for people under 30 or people who qualify for an exemption. They have a low premium and a very high deductible, cover the essential health benefits, preventive care at no cost and at least 3 primary care visits a year before the deductible. If you qualify for help, a Bronze or Silver plan may give you more for your money.

According to HealthCare.gov, all Bronze and catastrophic plans work with Health Savings Accounts (HSAs), and some plans in other levels do too. HSA money generally can’t be used to pay premiums.

Frequently asked questions