QUESTION

I notice Marketplace plans are labeled “bronze,” “silver,” “gold,” and “platinum.” What does that mean?

Individuals with no coverage | Comparing Plans: Benefits and Costs |
ANSWER

Plans in the Marketplace are separated into categories—bronze, silver, gold, or platinum—based on the amount of cost-sharing they require. Cost-sharing refers to out-of-pocket costs like deductibles, co-pays and coinsurance under a health plan. For most covered services, you will have to pay (or “share”) some of the cost, at least until you reach the annual out-of-pocket limit on cost-sharing. One exception is for recommended preventive health services, which health plans must cover entirely.

In the Marketplace, bronze plans generally have the highest deductibles and other cost-sharing. Silver plans will require somewhat lower cost-sharing, but this may not always be the case. If you are deciding between a bronze and silver plan, you will want to determine what the cost-sharing amounts are for the services you would use under each plan. Gold plans will have even lower cost-sharing. Platinum plans will have the lowest deductibles, co-pays and other cost-sharing. If you qualify for cost-sharing reduction subsidies, you’ll have your deductible and/or other cost-sharing reduced, but you must enroll in a silver plan to receive those benefits. (45 C.F.R. §§ 147.130, 156.130, 156.140.)

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