All health insurance plans in the market are broken into four metal tiers: Bronze, Silver, Gold, and Platinum. These metal levels differ in how the costs of your healthcare are split between you and your insurance company.
Generally speaking, plans with higher premiums have lower annual deductibles. Plans with lower monthly premiums tend to come with high deductibles.
The plan tier you choose depends entirely on your priorities and how often you predict needing medical care throughout the year. The bullet points below will help you determine which metal tier is right for you.
- You rarely get sick or need medical services, apart from an annual checkup and maybe a medication or two.
- You are very healthy and not elderly.
- If buying a family plan, your children are grown and healthy and don’t participate in risky activities.
- Expect to pay 40% out of pocket, 60% paid by your plan
- Your family members have one or two mild conditions that require some medication and specialist visits, but nothing needing close monitoring or frequent care.
- Your family members are able-bodied and under 70.
- Any kids are elementary age or older and healthy, and play few or no sports that often cause injury.
- Expect to pay 30% out of pocket, 70% paid by your plan
- You or a family member has a chronic condition, sees doctors frequently or needs expensive medication that would be impossible to afford out of pocket.
- Your children are preschool age or younger, needing frequent pediatrician visits.
- You may be older or at a higher risk for colds and flu than most people.
- Expect to pay 20% out of pocket, 80% paid by your plan
- You or a family member has an expensive chronic condition and takes several medications.
- You seek urgent or emergency care more than once per year on average, frequently need exams to manage a condition or see doctors more than once per month.
- You are older or at very high risk for colds, flu, or injuries.
- Expect to pay 10% out of pocket, 90% paid by your plan