Guides

Metal Tiers

The difference between Platinum, Gold, Silver, Bronze, and Catastrophic

Picking health insurance that works for you can be challenging, especially with all the factors that go into your final decision. From weighing what you need to be covered to how much you want to spend, figuring out what metal tier of health insurance best suits you can seem overwhelming.

The best way to start the process is to consider your medical needs. Will you need consistent medical care? Prescriptions? Once you know your answers to these questions, you can narrow down which metal tier of health insurance works best for you. Although it may seem confusing, the basics of health insurance tiers are meant to be simple.

Bronze, Silver, Gold, and Platinum make up the metal tiers. For example, Bronze tier has the lowest premium, but the highest prices for need-based care. On the other end, Platinum tier has the highest premium, but the lowest care prices. Platinum might be the best fit if you frequently need medical care and prescriptions. Gold is second to Platinum with a high premium and low need costs. Silver's pricing sits in the middle for both the premium and need-based costs; however, Silver tier allows you to qualify for cost-sharing reductions, which can help save on other out-of-pocket expenses like co-pays and co-insurance.

Catastrophic plans are another type of coverage. These plans generally have the the lowest premiums and the highest cost. The name comes from the basic idea that, outside of catastrophe, you bear much of the cost of care. While they cover all 10 essential health benefits outlined by the Affordable Care Act, these plans exist outside the metal tier framework. To enroll, you must be under 30 years old or else prove you are experiencing financial or other challenges that qualify you for this plan type (officially referred to as "affordability and hardship exemptions"). Catastrophic plans are also not eligible for government subsidies like premium tax credits.

The pricing on all these health insurance tiers varies. Even though every tier has a monthly premium, the total cost depends on which plan you choose and how much medical care you require.

The Break Down

Catastrophic: Has a low premium but very high cost for care. Annual deductible for out-of-pocket expenses: $8,700 for an individual in 2022, $9,100 for an individual in 2023.

Bronze: Has a low premium but a high cost per need. Estimation: Provider pays for 60% of care

Silver: Has a Middle range premium and a middle range cost per need. However, it allows you to qualify for cost-sharing reductions. Estimation: Provider pays for 70% of care

Gold: Has a High premium but a low cost per need. Estimation: Provider pays for 80% of care

Platinum: Has the Highest premium but the lowest cost per need. Estimation: Provider pays for 90% of care