To help make it easier for people to compare health insurance, the Affordable Care Act categorizes all health plans using types of metals: Bronze, Silver, Gold, and Platinum.
Each metal type tells you the share of covered medical expenses a health plan will pay versus what share of expenses you can expect to pay. Your share of expenses is often called your “out-of-pocket costs.”
No matter where you look for health insurance, whether on the Marketplace or directly through a health insurer, these metallic categories mean the same thing.
On average, plan pays 60%; you pay 40%
On average, plan pays 70%; you pay 30%
On average, plan pays 80%; you pay 20%
On average, plan pays 90%; you pay 10%
In general, the more the plan pays, the higher your monthly premium will be. So if you think you’ll use a lot of medical care, it would make sense to pay a higher premium for a gold or platinum plan, so you will pay less in out-of-pocket costs each time you need to use your benefits.
The opposite is also true: If you’re healthy, and really only need coverage for check-ups and emergencies, it may make sense to choose a silver or bronze plan with a lower monthly premium because you will pay the higher out-of-pocket costs less often.
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