What Are Affordable Care Act Silver Health Plans?

Q: Is there a national window for the annual ACA open enrollment period?

In most states , ACA open enrollment runs from November 1 to January 15 annually. Some states extend their deadlines to the end of January, and Idaho typically has an earlier deadline in mid-December.

Key takeaways:

Affordable Care Act (ACA) plans are organized into “metal tiers” — bronze, silver, gold, and platinum — that determine how costs are shared between consumers and insurance companies.
Silver health plans have the second-lowest monthly costs, with bronze plans having the lowest. Silver plans come with moderate monthly premiums and moderate out-of-pocket costs when accessing care.
Silver plans are known as “benchmark plans” because of their middle-of-the-road expenses when compared with the marketplace’s platinum, gold, and bronze plans.
You must choose a silver plan to qualify for cost-sharing breaks known as “extra savings,” which will reduce your deductible, copayments, and coinsurance amounts if you’re eligible.

The Affordable Care Act (also known as the ACA, or Obamacare) marketplace presents health plans in four “metal tiers.” Those metal categories — bronze, silver, gold, and platinum — bundle plans based on how consumers and insurers share costs. Bronze plans have the lowest monthly premiums and the highest out-of-pocket costs when you need care. On the other end of the spectrum, platinum plans come with the highest premiums and the lowest expenses when you receive care.

Silver plans offer moderate premiums and moderate charges for deductibles, copayments, and coinsurance. A silver health plan is the most common choice for people who buy health coverage through the ACA marketplace. It’s also the type of plan you must choose to receive “extra savings” that reduce out-of-pocket costs like deductibles, copays, and coinsurance.

What does a silver ACA health plan cover?

Silver plans and all other ACA marketplace plans must cover 10 essential health benefits, which are:

Emergency services
Hospitalization
Laboratory services
Mental health and substance use disorder services
Outpatient care
Pediatric services
Pregnancy, maternity, and newborn services
Prescription medications
Preventive care, wellness services, and chronic disease management
Rehabilitative and habilitative services and devices

What are the benefits of enrolling in a silver ACA health plan?

You must choose a silver health plan if you qualify for cost-sharing reductions known as “extra savings” and want to use them to reduce your out-of-pocket costs when you access care.

If you’re eligible, a premium subsidy, or a premium tax credit, could also help lower your costs by reducing your monthly payments for coverage. If you enroll in a bronze, gold, or platinum plan, you can still qualify for a premium subsidy, but you can’t get extra savings on out-of-pocket expenses related to care.

How much does an ACA silver health plan cost?

Your monthly premium for a silver plan will depend on your income, which plan you choose, and how many people are covered. You may qualify for a premium subsidy if your household income falls within 100% to 400% of the federal poverty level.

Depending on how much a premium subsidy reduces your monthly costs — and whether or not you qualify for cost-sharing reductions with a silver plan — you may be better off choosing a gold or platinum plan. These higher-value plans have lower out-of-pocket costs when you need care. You can use KFF’s health insurance marketplace calculator to estimate your premiums and subsidies for ACA plans.

In addition to your monthly premium, these out-of-pocket expenses affect your total annual costs.

Deductible

Your deductible is how much you will spend before your plan starts splitting the costs of your care. This doesn’t apply to preventive health services, however. Preventive health services, such as in-network checkups and screenings, are fully covered regardless of whether you’ve met your deductible.

EXPERT PICKS: WHAT TO READ NEXT

Know your metal tiers. Affordable Care Act (ACA) plans are grouped into metal tiers — bronze, silver, gold, and platinum — to represent how costs are split between insurers and enrollees.
Qualifying for coverage: You’re eligible for an ACA plan if you are a lawfully present U.S. resident who doesn’t have Medicare or other health insurance and isn’t incarcerated.
Don’t miss open enrollment. You can sign up for an ACA plan or renew coverage during the annual fall open enrollment period.

Copayments and coinsurance

Each time you get care that isn’t considered a preventive health service, you will likely be responsible for a copay or coinsurance. A copay is a fixed amount that you’re charged for a covered service after meeting your deductible. Coinsurance is a percentage of the cost of a service.

Out-of-pocket maximum

Also known as your out-of-pocket limit, this is the most you will have to pay for in-network, covered services in a plan year. If you spend this much on your deductible, copayments, and coinsurance, all covered services for the rest of the plan year will be paid in full by your insurance company. For the 2026 plan year, marketplace plans have out-of-pocket maximums of $10,600 for an individual and $21,200 for a family.

Silver vs. bronze, gold, and platinum ACA health plans

As mentioned, ACA health plans fall into four metal tiers, or value categories:

Bronze: These plans have the lowest monthly premiums but the highest costs when you need care.
Silver: Silver plans are known as “benchmark plans” because of their moderate monthly premiums and moderate out-of-pocket costs for care. You must choose a silver plan to qualify for cost-sharing reductions, which provide savings on out-of-pocket expenses such as deductibles, copayments, and coinsurance.
Gold: These plans have high monthly premiums but low costs when you need care.
Platinum: Platinum plans have the highest monthly premiums and the lowest costs when you need care.

Estimated Average Cost-Sharing for Covered Services

Plan category	Percentage paid by the insurance company	Percentage paid by the consumer
Bronze	60%	40%
Silver	70%	30%
Silver with extra savings	73%-96%	6%-27% (depending on the amount of extra savings you qualify for)
Gold	80%	20%
Platinum	90%	10%

Some states require health plans to be even more uniform to help customers compare them. These standardized individual health plans have the same deductibles, copayments, and coinsurance amounts.

Should I avoid a silver health plan?

A silver health plan may be the wrong choice for you if you expect to receive a lot of medical care and don’t qualify for extra savings. In this case, a gold or platinum plan may be better for you or your family. A premium subsidy may make a gold or platinum plan affordable for you on a monthly basis. And these plans have the lowest costs when you need care.

ACA enrollment involves completing an application, choosing a plan, and paying your first premium, if needed. The entry point is HealthCare.gov, the federal ACA marketplace. From there, you may be forwarded to another site if you live in Washington, D.C., or a state with its own marketplace.

If you have questions, contact a HealthCare.gov representative at 1-800-318-2596. This line is open 24 hours a day, 7 days a week — excluding holidays. You can also use this “find local help” tool to locate an ACA navigator in your area who can help you evaluate your options. Assistance from a call center representative or ACA navigator is free.

Frequently asked questions

In most states, ACA open enrollment runs from November 1 to January 15 annually. Some states extend their deadlines to the end of January, and Idaho typically has an earlier deadline in mid-December.

You may be eligible to choose an ACA catastrophic health plan if you qualify for a hardship exemption. Or you may be eligible based on an affordability exemption, if marketplace or job-based insurance is too costly for you. ACA catastrophic health plans are also available to people under 30 who want to select them for any reason and to older adults who don’t qualify for savings with a marketplace plan.

If you cannot afford an ACA (also known as Obamacare) plan, see if you qualify for Medicaid. Your ACA plan application can help you determine if you qualify for this state-based insurance program.

Premium subsidies are monthly discounts that reduce the cost of having an ACA health insurance plan. Also known as a premium tax credit, this discount is calculated based on your estimated income in a coverage year. If your actual income ends up being more than the estimate, it may result in a higher tax bill.

The bottom line

Selecting a silver health plan on the Affordable Care Act (ACA) marketplace may be the best choice for you or your family. Plans in this “metal tier” are the most common choice for consumers. Silver plans have moderate monthly premiums and moderate out-of-pocket costs when you receive care. And a premium subsidy, or premium tax credit, could help you pay less for your monthly premium.

If you qualify for extra savings on out-of-pocket expenses, you must choose a silver plan to receive them.

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Written by:

Brooke A. Lewis

Brooke A. Lewis is an award-winning journalist who has written on topics including health, race, and history.

Edited by:

Cindy George, MPH

Cindy George, MPH, is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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