What Are the Four Metal Tiers of Affordable Care Act Health Plans?

Affordable Care Act (ACA) health insurance plans are organized into four metal categories: bronze, silver, gold, and platinum. These tiers group plans based on how cost-sharing works. For example, bronze plans have the lowest premiums, but the highest costs when you need care. Platinum plans have the highest premiums, but the lowest costs when you access health services.

What to consider when picking an ACA metal tier

Choosing a health insurance plan can be difficult. To get started, you will need to estimate your household medical expenses and budget for the coverage year.

Consider how much care you and anyone else covered under your plan will need, and whether anyone takes prescription medications regularly. If you don’t expect to access much care, you might want to choose a bronze plan. If you think you’ll qualify for help with your out-of-pocket costs and want to take advantage of the savings, you must choose a silver plan. If you believe you will need regular medical visits and medications, you might want to select a gold or platinum plan.

There are three main areas to learn about before making your choice:

1. The four metal categories: Understanding the cost-sharing differences between plans in different ACA tiers of coverage can help you make the right decision for yourself and your family. Metal categories reflect how out-of-pocket expenses work. Metal tiers do not relate to the quality of care, though individual plans may have different quality ratings.

2. Total costs for insurance coverage: Having an ACA insurance plan involves paying a monthly premium, along with out-of-pocket expenses when you need care. Your premium is what you pay to your insurer for your plan each month, regardless of whether you use health services. When you receive care, you may have out-of-pocket expenses, such as a deductible, copays, or coinsurance.

3. Plan types and networks: ACA plans offer varying benefits, so research and compare different options. Networks can be limited or expansive for covered healthcare professionals and facilities. Some plans give you the ability to see almost any healthcare professional you want. Others require you to choose from healthcare professionals and facilities that are in network to avoid paying more. Choose a plan that gives you access to the benefits and healthcare professionals that you need.

What are the four metal tiers of coverage?

As mentioned, ACA plans fall into metal tiers that indicate how insurers and enrollees split the costs of care. The metal tier categories are:

• Bronze: These plans have the lowest monthly premiums, but highest costs when you need care.

• Silver: These plans are known as “benchmark” plans because of their moderate monthly premiums and moderate costs when you need care. You must choose a silver plan to qualify for cost-sharing reductions. These are also known as “extra savings” on out-of-pocket expenses such as deductibles, copays, and coinsurance.

• Gold: Gold plans have high monthly premiums, but low costs when you need care.

• Platinum: Platinum plans have the highest monthly premiums but the lowest costs when you need care.

Here’s how HealthCare.gov estimates average cost-sharing percentages for plans in different ACA tiers of coverage.

What are the costs of ACA health plans?

Any ACA plan you choose will have a monthly premium. If you qualify, a premium tax credit — also known as a premium subsidy — could reduce your monthly bill.

A KFF national analysis of marketplace plans found that the average benchmark premium (the second-lowest-cost silver option) for a 40-year-old is $625 in 2026. Enhanced premium tax credits were eliminated for the 2026 coverage year. As a result, many people have much higher premiums. Average benchmark premiums in 2026 range from $401 in New Hampshire to $1,299 in Vermont.

Your total plan-related costs will depend on what kind of coverage you choose and how much you access care. Your monthly premium will be the same throughout the coverage year, unless you have what’s known as a qualifying life event and switch plans. Beyond your monthly premium, there are out-of-pocket costs that will affect your annual spending:

• Deductible: This is how much you will spend before your insurance begins splitting the cost of your care. However, the deductible doesn’t apply to preventive health services. Routine care, such as in-network checkups and screenings, is covered regardless of whether you’ve met your deductible.

• Copays 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 pay for a covered service, typically — but not always — after meeting your deductible. Coinsurance is a percentage of the cost of a service after you’ve paid your deductible.

• Out-of-pocket maximum: Also known as your out-of-pocket limit, this is the most you will have to pay for covered services in a plan year. If spending on your deductible, copays, and coinsurance reaches this amount, all covered services will be paid in full by your insurance for the rest of the year. For 2026 marketplace plans, the out-of-pocket maximums are $10,600 for an individual and $21,200 for a family. For 2027 marketplace plans, the out-of-pocket maximums are $12,000 for an individual and $24,000 for a family.

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What are catastrophic health plans?

Catastrophic health plans are for people who want to protect themselves from huge bills in the case of a serious illness. Catastrophic plan premiums are very low. But these plans tend to have an extremely high annual deductible, which must be met before benefits — other than coverage for preventive health services and a limited number of primary care visits — kick in.

In 2026, ACA catastrophic health plans have an annual deductible of $10,600 for an individual or $21,200 for a family. In 2027, the annual deductibles are set at $12,000 for an individual and $24,000 for a family. These deductibles are equal to the annual out-of-pocket maximums for ACA plans.

Catastrophic plans are available to people under 30, people 30 and older who don’t qualify for savings on ACA coverage, and people of any age with a hardship or affordability exemption. A hardship or affordability exemption is usually given when a person can’t pay for marketplace premiums or job-based insurance because of a qualifying circumstance. Examples of qualifying circumstances are:

• Being homeless

• Being evicted, facing eviction, or facing foreclosure

• Experiencing domestic violence

• Experiencing major damage to personal property from a natural or human-made disaster, such as a flood or fire

• Receiving a shut-off notice from a utility company

• Experiencing the death of a family member

• Filing for bankruptcy

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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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