Metallic tiers is a health plan categorization system that's based on the percentage the plan pays of the average overall cost of benefits to members. The plan category you choose affects the total amount you'll likely spend for essential health benefits during the year.
The Affordable Care Act requires each metal tier to cover a certain percentage of your health care costs.
- Bronze plans must cover at least 60% of essential health benefits
- Silver plans must cover at least 70% of essential health benefits, unless you're eligible for cost sharing reduction. *
- Gold plans must cover at least 80% of essential health benefits
- Platinum plans must cover at least 90% of essential health benefits
Note: Silver plans are a little different. You may be eligible for a cost sharing reduction subsidy. Depending on your income, this subsidy means you could qualify for a silver plan that covers about 73, 87, or 94 percent of your healthcare costs.