What are the Metal Levels in Marketplace Insurance?

When you start planning for Open Enrollment, your first question may be which metal level of health coverage is right for you. Health insurance plans in the Marketplace fall into four metal-level tiers: Platinum, Gold, Silver, and Bronze. These metal levels reflect the differences in how costs for your healthcare are split between you and your insurance company. Generally speaking, plans with higher premiums have lower annual deductibles. And plans with lower monthly premiums tend to come with high deductibles. Depending on the amount of medical costs you end up with in a year, different metal levels will offer different kinds of value to you.

The different metal tiers in no way reflect a difference in the level of care you receive.

Thanks to the Affordable Care Act, all Marketplace plans must cover the following 10 categories of Essential Health Benefits:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

No matter which plan type you select, all Marketplace plans are Qualified Health Plans. And these plans must offer a set of preventive care services – including many vaccinations, cancer screenings, and birth control – for free when you visit an in-network healthcare provider, even if you haven’t met your deductible yet.

Take Charge of Your Savings
Earn rewards for creating a brighter future
Sign up to save more

Recommended Articles

How to Get the Most Out of Your Health Savings Account

Looking to save and invest your money over time? One resource that you can take advantage of is in a very unlikely place: your health care. Introduced in 2003, health savings accounts, or HSAs, can help you reduce healthcare costs and increase your long-term savings. Learn more about HSAs, and how you can get the… Read more

Program Spotlight: WIC & CHIP

SaverLife member Tiffany often feels like she has to make tradeoffs between providing her family with nutritious food and reliable healthcare and ensuring that her other bills are paid on time. “Just eating healthier is so expensive,” she explains. To make sure that her family has access to nutritious food and quality care, Tiffany takes… Read more

Government Benefits Roundup: How to Tell Which Programs Are the Best Fit for You

Unsure which benefits and assistance programs are the right fit for you? Get the basics on the most common government assistance programs below.  Pro Tip: It’s important to understand that the eligibility requirements for programs can change. For example, some states like North Carolina recently expanded Medicaid options. If you were previously denied assistance through… Read more