What are the metallic tiers of health coverage?

When shopping for individual coverage on private or public health exchanges, you’ll likely see plans labeled Bronze, Silver, Gold, or Platinum. These “metal tier” categories can help you compare how much you’ll pay in monthly premiums with how much you’ll potentially pay for covered services.

But choosing a health insurance plan is more than just picking the lowest premium or highest value. A plan with a lower monthly premium may come with higher out-of-pocket expenses, while a policy with a higher premium rate can help you save money when you need medical care.

Your first step is to understand the ins and outs of the metal tier system so you can choose the coverage that fits your medical needs and finances.

In this blog post, you’ll learn:

• What Bronze, Silver, Gold, and Platinum health insurance plans mean and how they differ.
• How metal tiers affect your monthly premiums, deductibles, and other out-of-pocket costs.
• How metal tiers work with an individual coverage health reimbursement arrangement (ICHRA) and federal healthcare subsidies.

What does metal tier mean in health insurance?

Metal tiers are categories the federal Health Insurance Marketplace, state-based exchanges, and insurance carriers use to organize individual health plans based on how you and your insurance company split the cost of covered medical services. The four metal tiers arranged from lowest to highest are Bronze, Silver, Gold, and Platinum.

A higher metal tier doesn't mean you’ll receive better quality of care or more covered services. It only means the insurance carrier pays a larger share of your medical expenses.

Your plan's metal tier also doesn't tell you everything about the plan. Two silver plans, for example, can have different deductibles, copayments, coinsurance, and provider networks. So it’s important to compare all of the plan details before enrolling.

How do metal tiers affect your health insurance premium?

Your premium is the amount you must pay each month to keep your coverage active, whether or not you need medical care. In general, the higher the metal tier, the higher the monthly premium.

Bronze plans typically have the lowest premium among the four metal tiers, while Platinum plans have the highest. But there’s a tradeoff. A Bronze plan may have cheaper monthly premiums, but you’ll pay more out of pocket when you need medical treatment. A Gold plan will likely have higher monthly premiums but can have lower costs for healthcare services.

However, the plan with the lowest monthly premium isn't necessarily the plan that will cost you the least overall. Other factors will also determine your actual premium payment. In addition to the metal level, your age, ZIP code, tobacco use, family status, and the insurance carrier can all affect what you pay if you’re buying an ACA-compliant plan on- or off-exchange.

How do metal tiers affect your cost-sharing amounts?

Cost-sharing is your portion of covered healthcare costs that you must pay when you receive medical care. Most commonly, cost-sharing includes your deductible, copayments, and coinsurance.

Metal tier plans use a measurement called actuarial value, which estimates the percentage of covered healthcare costs that a plan will pay for a standard population.

According to the Centers for Medicare & Medicaid Services (CMS), the standard actuarial values are as follows¹:

Actuarial value isn't an exact prediction of how much your insurance company will pay toward your healthcare expenses. For example, a Silver plan has an actuarial value of 70%. This means the plan will pay about 70% of covered healthcare costs for a standard population, while consumers pay about 30% through cost sharing. However, your actual costs will depend on your plan's deductible, copays, coinsurance, and out-of-pocket maximum.

These variations are why two plans in the same metal tier can have different cost-sharing amounts. One Bronze plan can have a higher deductible but a lower coinsurance rate, while another might have a lower deductible and a higher coinsurance rate. The plans are still in the same category, but your out-of-pocket costs will vary.

What's the difference between each metal tier?

The easiest way to think about the metal tiers is as a tradeoff between what you pay each month and what you pay when you use healthcare. The right choice depends on your expected healthcare needs, budget, and the level of financial risk you're comfortable taking on.

1. Bronze plans

Bronze plans have the lowest monthly premiums of the four metal tiers, but higher out-of-pocket costs when you receive care. They usually cover about 60% of expected healthcare costs for a standard population, meaning you’ll typically pay the remaining 40% through deductibles, copayments, and coinsurance.

A Bronze plan may make sense if you:

• Want to keep your monthly payments low.
• Don't expect to need healthcare services or items often.
• Can afford a higher annual deductible if you need major medical care.
• Prefer to pay less each month in exchange for potentially higher out-of-pocket costs.
• Have a health savings account (HSA)
• Under the One Big Beautiful Bill Act (OBBBA), on-exchange Bronze and catastrophic health plans and their mirrored off-exchange versions are HSA-qualified as of 2026.

2. Silver plans

Silver plans offer a middle ground between monthly premiums and out-of-pocket costs. They have an actuarial value of about 70%, so you’ll pay roughly 30% of your covered medical expenses.

Silver plans are especially important if you qualify for cost-sharing reductions (CSRs). CSRs offer additional savings that can lower your deductible, copayments, coinsurance, and other out-of-pocket costs. But they are only available to you if you enroll in a qualifying silver plan on a public exchange

(Note: If your employer offers an affordable ICHRA contribution, you’ll be ineligible for any premium tax credits (PTCs) and CSRs. If your ICHRA is unaffordable and you opt into it anyway, you’ll be ineligible for PTCs).

A Silver plan may be a good fit if you:

• Want a balance between your monthly premium and costs when you receive care.
• Expect to use healthcare somewhat regularly.
• Qualify for cost-sharing reductions.
• Want to moderate premiums and moderate out-of-pocket costs.

In some cases, Silver plans can have higher premiums than Gold plans on the same local market due to a process called “silver loading.” When insurers adjust Silver plan premiums to account for the loss of federal cost-sharing reduction payments, they apply those increases only to Silver plans. As a result, you may see a Gold plan with a lower monthly premium than a Silver plan, even though the Gold plan might offer more comprehensive coverage.

3. Gold plans

A Gold insurance plan typically has higher monthly premiums but lower out-of-pocket costs when you use healthcare. These policies have an actuarial value of about 80%. Therefore, they’ll pay 80% of expected covered medical costs for a standard population, and you’ll pay the remaining 20%.

A Gold plan may make sense if you:

• Expect you’ll need frequent medical care.
• Take regular prescription drugs or specialty medication.
• Have ongoing healthcare needs requiring regular treatment.
• Prefer paying more each month to lower out-of-pocket costs when you receive care.

4. Platinum plans

Platinum plans generally have the highest monthly premiums and the lowest out-of-pocket costs of the four metal levels. Because they have an actuarial value of about 90%, you can expect to pay around 10% of your medical expenses for covered services out of pocket if you have a platinum policy.

A Platinum plan may be worth it if you:

• Expect to use a lot of healthcare throughout the plan year.
• Have significant ongoing medical expenses due to a chronic illness or other disease.
• Want lower out-of-pocket costs when you need medical care.
• Can afford the higher monthly premium.

Platinum plans aren't available in every state, so your options will depend on where you live.

Catastrophic plans

Catastrophic policies aren't official metal plans, but CMS describes catastrophic coverage as having an actuarial value below the Bronze level. These plans usually have the lowest premiums, but rates can vary by age, ZIP code, and plan. Unlike Bronze, Silver, Gold, and Platinum plans, you can’t use premium tax credits to reduce the cost of catastrophic plans.

For 2026, the annual deductible for a catastrophic plan is $10,600 for individual coverage and $21,200 for family policies². They typically don’t have a coinsurance rate because they don’t pay until you meet your deductible. However, like other Marketplace plans, they will cover certain preventive care services at no cost and will pay for at least three primary care visits before you meet your deductible³.

Catastrophic health insurance plans aren’t offered in every state. However, if they’re available in your area, people younger than age 30 are generally eligible. People 30 and older may also qualify if they meet certain hardship or affordability exemption requirements⁴.

Metallic tiers of insurance coverage comparison chart

To make it simple, the following chart compares the main differences between the metal tiers. Remember, your actual premium, deductible, and other cost-sharing amounts will vary by plan.

How do metal tiers interact with an ICHRA?

An individual coverage health reimbursement arrangement (ICHRA) allows employers to set a tax-free monthly contribution amount to offer their employees. Once participating employees select and enroll in their own qualifying individual health plan, they can use their employer’s contribution to help pay their monthly premiums.

An ICHRA doesn't require you to choose a particular metal tier to use the benefit. For example, you could choose a Bronze plan if you want a lower premium, or a Gold plan if you're willing to pay more each month for lower out-of-pocket costs. In either case, you can use your ICHRA contribution to go toward your premiums.

But your ICHRA can affect premium tax credit eligibility. If the IRS considers your ICHRA affordable, you can't receive a premium tax credit for Marketplace coverage, even if you decline your benefit. In this case, it’s best to opt into the ICHRA and waive your subsidy (if you’re eligible).

If the ICHRA is unaffordable, you must choose between the ICHRA and receiving your premium tax credit — you can't have both. If you’re eligible for the subsidy and want to collect your tax credits, you must opt out of the ICHRA.

In 2026, an ICHRA is affordable if your monthly premium for the lowest-cost self-only Silver plan on your local exchange, minus your monthly ICHRA contribution, doesn’t cost more than 9.96% of your monthly household income. This applies even if you choose a Bronze, Gold, or Platinum health plan.

Conclusion

Choosing a metal tier is ultimately a decision about how you want to balance your monthly premium with your future healthcare costs. If keeping your monthly premium as low as possible is your top concern, a Bronze tier plan may be your best option. In contrast, a Gold or Platinum plan may make more sense if you need frequent medical care and can pay more out of pocket.

If you need help finding the right plan for you, and your employer offers an ICHRA through Remodel Health, our platform and team provide personalized support to help members compare plan options and enroll in qualifying coverage so they can get the most out of their benefit.

References

1. CMS - Actuarial Value and Cost-Sharing Reductions Bulletin
2. KFF - FAQs: What is a Catastrophic health plan?
3. HealthCare.gov - Catastrophic health plans
4. HealthCare.gov - Health Coverage Exemptions: Forms and How to Apply
5. KFF - 2026 Average Monthly Marketplace Premiums by Metal Tier
6. KFF - Deductibles in ACA Marketplace Plans, 2014-2026