The 4 Metal Levels of Health Insurance: What Amount of Coverage is Right for You?
When researching health insurance plans, you're likely to come across the 4 same words again and again—Bronze, Silver, Gold, and Platinum. But what do these mean? In most cases, health insurance policies are divided into 4 different levels labeled as metals. These indicate the general price of their premiums, how high or low the deductibles are, and the percentage of medical fees that you and your insurance will pay. Get a better idea of what each of the metal levels mean so you can make a smart decision about your health and financial future.
|Premiums: Low||Deductibles: High||After deductible, insurance pays: Around 60%||You pay: 40%|
At the bottom of the 4 metal tiers is Bronze, which provides the least amount of financial coverage for your medical costs. These plans have the lowest monthly premiums but high deductibles, meaning that if you end up needing a lot of care, you'll pay a significant portion out of pocket. The coinsurance is also the highest, so even after meeting your deductible, you'll still be required to pay for around 40% of your covered medical services.
Recommended if: You're young and healthy, don't take expensive prescription drugs, and want a low-cost way to protect yourself against serious sickness or injury.
|Premiums: Moderate||Deductibles: Moderate||After deductible, insurance pays: Around 70%||You pay: 30%|
Next up is Silver, offering about 10% more financial coverage than Bronze after you've met your deductible. These deductibles are typically more moderate, and the monthly premiums are less. If you're eligible, these plans can also offer the benefit of extra savings through tax credits and cost-sharing reductions.
Recommended if: You want added protection to cover more routine care but still don't require much medical attention. You can either afford the increase in monthly premiums or you qualify for extra savings.
|Premiums: Highest||Deductibles: Low||After deductible, insurance pays: Around 80%||You pay: 20%|
Gold plans come with high monthly premiums but require less out-of-pocket payment for medical services you receive. Deductibles are usually low, so your insurance kicks in more quickly than for Bronze or Silver policies. After you've met your deductible, most Gold insurance plans cover around 80% of your medical fees, leaving you with just 20% of the costs.
Recommended if: You receive a good amount of medical care, take expensive prescription drugs, or have a chronic but not too serious condition.
|Premiums: Highest||Deductibles: Very low||After deductible, insurance pays: Around 90%||You pay: 10%|
These plans have the most expensive premiums, but they also offer the lowest deductibles and highest percentage of coverage—generally around 90% of your qualifying medical services. That means that while you pay significantly more each month, when you do need treatment, you can rest assured that nearly all of the other costs will be taken care of by your insurance.
Recommended if: You receive a lot of healthcare services, particularly from specialists, take several different prescription drugs, or know you're going to need a number of lab tests.
|Premiums: Lowest||Deductibles: Highest||After deductible, insurance pays: Around 100%||You pay: 0%|
Though not technically one of the metal levels, another option is Catastrophic coverage, but you need to meet strict requirements in order to qualify. These plans are designed for people under 30 or those who are eligible to receive hardship exemptions. While these have the lowest monthly rates of any of the plans, the deductibles are also very high. As of 2019, people on these plans need to pay $7,900 out of pocket before any insurance kicks in. The good news is that certain preventive services and primary care visits are still covered at no cost to you. What's more, if you do reach your deductible, 100% of all covered services are paid for.
Recommended if: You're under 30 and healthy or you qualify for a hardship exemption. You're at low risk for needing medical care outside of preventive services.