What is the difference between bronze, silver, etc. health insurance plans?

Individual health insurance plans are split into four levels: bronze, silver, gold, and platinum, with bronze being the lowest and platinum the highest. These names refer only to the financial aspects of the plan. The level of the plan you purchase has no bearing on the quality or amount of care you are able to receive.

Lower-level plans typically have lower premiums but higher deductibles, and you will have to pay a greater percentage of the claim after the deductible as well. Higher-level plans have higher premiums, but are more financially friendly in other respects. The maximum amount you can pay out-of-pocket will also likely differ between levels. Overall, lower-level plans are better choices for those who expect to make few claims during the course of the year, while higher-level plans are better for those who intend to get a lot of use out of their insurance. Take a look at our “Finding the Plan That’s Right for You” article to learn more about calculating which level of plan is best for your situation, including how subsidies can play into such calculations.

If you want to get into technical details, the real difference between the levels is in their actuarial value, or AV. This value is calculated based on the average percentage of enrollee medical costs that a particular plan will pay. It should be noted that this is calculated across all enrollees, and not done on an individual basis. On average, a bronze-level plan pays 60% of its enrollees’ costs, a silver plan 70%, a gold plan 80%, and a platinum plan 90%.

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