Understanding Health Insurance Metal Levels

What Does Metal Level Mean In Health Insurance?

 

The Health Insurance Marketplace classifies different types of health insurance plans by "metal" levels. There are four different metal tiers: Bronze, Silver, Gold, and Platinum. Check for availability, as not all metal level plans are available in all areas.

How Do The Metal Levels Differ?

 

Metal levels differ only in how you and your insurance provider share the overall cost. 

Plan

Bronce

Silver

Gold

Platino

Lo que paga tu plan

60%

70%

80%

90%

Su costo

40%

30%

20%

10%

Do The Different Metal Levels Offer Different Benefits?

 

No. All Health Insurance Marketplace plans, regardless of metal level, cover the same 10 essential health benefits:

  1. Servicios para pacientes ambulatorios (atención a pacientes ambulatorios que recibe sin ser admitido en un hospital)

  2. Servicios de emergencia

  3. Hospitalization (surgery and overnight stays)

  4. Pregnancy, maternity, and newborn care 

  5. Mental health and substance use disorder services, including behavioral health treatment (includes counseling and psychotherapy)

  6. Medicamentos recetados

  7. Rehabilitative services and devices (used to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)

  8. Servicios de laboratorio

  9. Servicios preventivos y de bienestar, y administración de enfermedades crónicas

  10. Pediatric services, including oral and vision care for children
     

While all Marketplace plans provide the basics, you can select plans through your insurer that include more comprehensive coverage including dental and vision insurance.

 

 

What Metal Level Is Best For Me?

 

When you compare metal levels, think about the kind of coverage you need and how it fits your budget. 

 

Bronze Level Plans 

A bronze plan costs the least in monthly premiums for coverage. Bronze is the most cost-efficient coverage plan.

 

  Lowest premiums
 

  Highest deductibles
 

  Savings for those with fewer healthcare needs

 

Silver Level Plans 

Silver plans offer slightly higher premiums than Bronze plans, but your annual deductible will be lower. By choosing a Silver plan, you may also be eligible for extra savings called cost-sharing reductions, which lower your overall costs.

 

  Moderate premiums

 

  Lower deductibles

 

  Cost-sharing potential for family size and income

 

Gold Level Plans 

Gold plans can help you save if you use your healthcare often. While you pay a higher premium, you will save on annual deductibles.

 

  Higher premiums

 

  Lower deductibles

 

  Low cost for frequent healthcare needs

 

Platinum Level Plans 

Platinum plans require higher premiums but can be the best savings option when you require a lot of healthcare and are willing to pay a high monthly premium, knowing nearly all other costs will be covered.

 

  Highest premiums

 

  Lowest deductibles

 

  Coverage of nearly all healthcare costs

 

 

What Savings Are Available For Each Metal Level?

 

Silver Level Cost-sharing Subsidies

Cost-sharing subsidies are based on your income level and help share out-of-pocket costs like deductibles, copays, and coinsurance. They are available only with a Silver plan.

 

Premium Tax Credits For All Metal Levels

Premium tax credits are based on your earnings and family size (including yourself, your spouse, if married, and anyone you will claim as a tax dependent — even if they do not need coverage). They are available for any metal level. Si calificas, es posible que puedas reducir o eliminar por completo tu prima. 

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