What are Bronze, Silver, Gold, and Platinum Health Insurance Plans?

There are four coverage level options for health insurance plans compliant with the Affordable Care Act:

  • Bronze – lowest cost with highest out-of-pocket expenses (40% coinsurance)
  • Silver – midrange plan with 30% coinsurance
  • Gold – upper-midrange plan with 20% coinsurance
  • Platinum – highest coverage and cost with lowest out-of-pocket expenses (10% coinsurance)

Coinsurance is an aspect of health care cost-sharing. Once you pay your copay and meet your annual deductible, coinsurance activates. If you have 40% coinsurance, you will pay 40% of the bill while your insurer pays 60% of the medical charges. Likewise, if you have 10% coinsurance, your insurer pays 90% of medical costs.

A copay is a fee you pay to the provider at the time of service. Typically, for a primary care physician, it costs $5-30 per visit. Emergency room visits may charge a higher copay, like $150-250.

A deductible is an amount you pay towards your health care costs each year before the insurance company starts paying the large bills. Often, prescription drugs have a separate deductible from medical treatment.

When Shopping for Health Insurance

Comprehensive Coverage

All ACA-compliant plans include essential health benefits like outpatient services, emergency services, hospitalization, preventative medicine, chronic disease treatment, and more.

Access to Essential Care

All plans cover specific preventative care at no additional cost.

Some services, like annual check-ups and routine mammograms, may be 100% covered if you use in-network providers.

ACA-compliant plans also guarantee access to other vital medical care:

  • Hospitalization overnight
  • Emergency room or urgent care visit
  • Physical therapy & rehabilitative treatment
  • Care for children

Cost Sharing

Typically, all health insurance plans build-in cost-sharing. The amount you pay depends on which plan level you choose.

If you want the insurer to pay a higher percentage of your medical bills, choose a gold or platinum plan. It will have a higher up-front cost as a premium, but you spend less on the back end.

Copays are a method of cost-sharing. Most plans and services require you to pay a copay for treatment.

The copay amount will vary depending on whether you see your primary care physician, a specialist, or an emergency room. Copays can also vary between plans. A bronze plan will have a greater copay than a gold plan.

We always recommend reading your plan documents closely and asking AARDY about anything you do not understand. You will avoid expensive surprises down the road.

Government Subsidy

The federal government offers financial assistance with health insurance, depending on your income level and household size.

How to Choose a Health Insurance Plan

It can be overwhelming to choose a health insurance plan. There are so many variables and prices, it is hard to know where to start.

  • Consider past, present, and future medical needs. Suppose you have a chronic illness or see a doctor frequently with accident-prone children. You may save more money buying a gold or platinum plan and paying less each time you visit the doctor. On the other hand, if you are healthy and do not even take prescription medications, a bronze or silver plan might fit better.
  • Make sure the plan covers your needs. You can view the policy document before enrolling in a program. Check what treatments, illnesses, and medications it covers and how much it pays for them.
  • Choose a plan that fits your budget. If you are disciplined to save money for a rainy day, you may find a bronze or silver plan will work best. You can use your savings if you must. But as long as you are healthy, you can save the money you would otherwise spend on insurance premiums. Also, check to find out if you qualify for a federal subsidy. It can help you save on your monthly costs.

Where Can I Get the Lowest Price on Health Insurance?

AARDY is the nation's fastest health insurance market. We can help you find the best health insurance plan. Our service compares Affordable Care Act and Short Term plans so you can find the best fit.



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