What are the metallic tiers of health insurance coverage?

By Holly Bengfort on October 13, 2026 at 10:30 AM

One goal of the Affordable Care Act (ACA) in the United States is to improve access to affordable health insurance plans for individuals without employer-sponsored coverage. The state and federal Health Insurance Marketplaces categorize plans into standard levels. This helps individuals find the right insurance policy more easily.

If you're ready to buy individual health insurance, your first step is understanding the different metal levels of plans. All marketplace plans cover the ten essential health benefits, such as preventive services and mental health services. But each has different ratios of what you pay and what your health insurance company pays for medical costs.

For 2027 Open Enrollment, understanding these metal levels can help you compare plans based on your monthly budget and what you may pay when you need medical care.

In this blog post, you'll learn:

What actuarial value is and why it matters.
The relationship between metal levels, health insurance premiums, and out-of-pocket costs.
How to choose the metal level that best fits your situation.

What are the metal tiers in health insurance?

The federal government groups marketplace plans into four coverage levels. They're called health coverage tiers, metallic tiers, or metallic levels.

Metallic tiers only affect how you and your health insurance provider split healthcare costs. They don't influence the quality of care you receive or the provider network availability.

When you look at a health insurance plan option, you'll notice that your total medical expenses include common health insurance terms like premiums, deductibles, and out-of-pocket costs, such as copayments and coinsurance amounts.

A more expensive metal tier (generally an ACA plan with a higher premium) means the health insurer pays a higher share of your medical expenses. A less expensive tier (usually a plan with a lower premium) means that you incur higher out-of-pocket medical costs. Again, these categories have nothing to do with the quality of care you receive.

The four metallic levels, from lowest to highest premium cost, are:

Bronze
Silver
Gold
Platinum

Each metallic tier includes various plan types, such as health maintenance organization (HMO) or preferred provider organization (PPO) plans. The plan type determines where you can get comprehensive care and what you pay for medical services and medications.

What is the relationship between metal tiers and health insurance premiums?

As you may already know, individual health insurance premiums and deductibles vary based on:

Where you live
Your insurance carrier
Your plan's metal tier
Your age and household circumstances
Whether you qualify for Marketplace financial assistance

Average premium costs relate to the amount of health insurance coverage a plan provides. Higher-tier plans, like Gold or Platinum, mean you'll pay higher monthly premiums. In lower-tier plans, like Bronze or Silver, you may pay less in premiums but have a higher deductible.

Here are the projected average monthly premiums for each metal tier in 2026¹:

Average-lowest cost Bronze premium: $456
Average-lowest cost Silver premium: $611
Average-lowest cost Gold premium: $615

While the exact rates aren’t finalized yet, insurers have proposed a median Marketplace premium increase of 15% nationally for the 2027 plan year².

Remember, no matter which plan you select, all ACA plans are qualified health plans. That means they must offer a set of preventive care services with no copayments.

Metal level impact on premiums and out-of-pocket costs comparison chart

The table below provides a quick comparison of the relationship between monthly health insurance premiums and costs when you receive medical care.

Metal level	Monthly premium	Out-of-pocket costs	Who this metal level may be best for
Bronze	Lower	Highest	Individuals who expect to use less healthcare and want a lower monthly premium
Silver	Moderate	Moderate	People who want to balance premiums and out-of-pocket costs
Gold	Higher	Lower	Individuals who expect to use more healthcare and can afford a higher premium
Platinum	Highest	Lowest	Consumers who expect significant healthcare use and want lower costs when receiving care

Actual premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums will vary by plan, insurer, location, and individual circumstances.

What is actuarial value?

Actuarial value is the percentage of costs a health plan covers relative to what the individual policyholder pays. You calculate actuarial value by dividing the total expected payments for essential coverage by the total expected costs of the “standard population” for essential health benefits.

Average actuarial values determine the cost-sharing baseline between you and your health insurance carrier. Because actuarial value is based on a standard population, the cost-sharing structure could vary from one plan to another, so your actual costs may differ.

For example, a plan with a higher deductible may have a lower coinsurance to offset it to reach the plan's desired actuarial value. Another plan may compensate for a high deductible by covering a few services completely before the policyholder meets the plan's deductible.

Metal level	Actuarial value	Average share paid by the plan	Average share paid by the consumer
Bronze	60%	60%	40%
Silver	70%	70%	30%
Gold	80%	80%	20%
Platinum	90%	90%	10%

For example, a Silver plan has an actuarial value of 70%. This means the plan will pay about 70% of the average cost of covered benefits for a standard population, and the plan holder can expect to pay about 30% through cost-sharing.

The goal of the actuarial value structure is to keep all participants in the same metal-level plan paying the same cost of care. However, out-of-pocket costs vary by plan and the medical services you may need, so read each plan's summary of benefits to understand its structure before enrolling.

What's the difference between each metal tier?

We'll go over each tiered plan in more detail below to help you understand how they work.

Bronze plans

The Bronze health plan has an average actuarial value of 60%. This means covered individuals typically pay 40% of their expected medical expenses. Bronze metal-tier plans usually have the lowest monthly costs, so they can be very appealing if you're looking for the cheapest option. But Bronze plans also have the highest annual deductibles.

These lower-tier plans can come with financial risk. You could be stuck paying high costs when you need healthcare, such as paying several thousand dollars out of pocket before your health insurance company starts chipping in.

However, as of 2026, on-exchange Bronze plans (and the same plan’s off-exchange versions) have a perk. The One Big Beautiful Bill Act (OBBBA) has now made most catastrophic and Bronze plans HSA-qualified³. This means individuals with these plans can now contribute to a health savings account (HSA). This may let you save money on premiums by choosing a Bronze plan and using an HSA to offset the higher deductible.

A Bronze plan may be right for you if:

You're looking for a lower monthly payment.
You only have a few expected medical needs.
You want to contribute to an HSA.

However, you could face a steep bill if you suddenly need major medical care.

Silver plans

The Silver health plan has an average actuarial value of 70%. Covered individuals pay 30% of their expected medical expenses. Many Marketplace enrollees prefer Silver-tier plans because they usually have moderate monthly premiums and out-of-pocket costs when you need care. With a Silver plan, your annual deductible is lower than with a Bronze plan.

A key feature of Silver-tier plans is that they may include cost-sharing reductions (CSRs) based on your household income and family size. Cost-sharing reduction subsidies only apply to Silver-level plans. Meeting the requirements may provide additional savings each year when you use different healthcare services.

If you qualify for a CSR, which is available to people with a household income up to 250% of the federal poverty level, you can reduce your out-of-pocket costs. Advance premium tax credits are also available to people who earn between 100% and 400% of the federal poverty level. These types of tax subsidies reduce your health insurance premium.

Some Silver plans may be more expensive than Gold plans. This is because some states have silver loading.

A Silver plan may be right for you if:

You use healthcare services moderately.
You qualify for cost-sharing reductions.

You may pay a higher monthly premium than a Bronze plan, even with subsidies, but you'll receive more comprehensive coverage in return.

Gold plans

The Gold health plan has an average actuarial value of 80%. Covered individuals only pay 20% of their expected medical expenses. Gold plans have high monthly premium rates but lower out-of-pocket costs because they typically have very low deductibles. This means you'll start seeing extra savings sooner if you access a lot of healthcare in a given year.

A Gold plan may be best for you if:

You can afford the monthly premium.
You want lower medical care costs rather than unpredictable out-of-pocket expenses.
You have a chronic condition.
You expect to need a lot of care during the year.
You live in a state with silver loading.

When comparing Gold with a lower metal level, consider your total potential annual costs, not just your monthly premium.

Platinum plans

The Platinum metal plan has an average actuarial value of 90%. Covered individuals pay only 10% of their expected medical expenses. It has the highest monthly premium rates and the lowest annual deductibles of all the tiers. This means you'll save more quickly if you need a lot of medical care.

A Platinum health plan may be best for you if:

You use a lot of healthcare services.
You have a serious medical condition.
You can afford the high monthly premium.
You prefer lower cost-sharing when receiving covered care.

But because Platinum plans are expensive and not available in every county, KFF found that only 0.4% of total marketplace enrollees opted for a Platinum plan in 2026.⁴

What are catastrophic health insurance plans?

Catastrophic health insurance plans are your cheapest choice for health coverage. They fall below the Bronze tier. They have low monthly premium rates but high deductibles. These plans offer qualified individuals health insurance coverage for medical emergencies or after a serious injury.

Like metal-tier plans, catastrophic plans must cover certain preventive health services at no charge. These plans also provide covered benefits of three primary care doctor visits a year before you meet your deductible. After that, the plan will pay 100% for in-network essential coverage for the rest of the year.

According to the Centers for Medicare & Medicaid Services, the annual deductible for catastrophic coverage in 2027 is $12,000 for individual coverage and $24,000 for family coverage⁵.

Catastrophic plans are separate from the four ACA metal levels and have their own eligibility requirements. They’re for people younger than 30 or those who have a hardship exemption citing special circumstances. These circumstances include homelessness, facing eviction or foreclosure, facing significant medical debt, or having filed for bankruptcy.

How do you choose the right ACA metal level?

There's no single metal level that's right for everyone. Consider the following when comparing ACA plans:

Your expected healthcare use. If you expect frequent doctor visits, regular prescriptions, or ongoing treatment, a higher metal level may reduce what you pay when receiving care.
Your monthly budget. If keeping your monthly premium rate as low as possible is your priority, a Bronze plan may be worth considering.
Your potential out-of-pocket costs. Look at the deductible, copayments, coinsurance, and out-of-pocket maximum — not just the monthly premium rate.
Your eligibility for Marketplace savings. Premium tax credits can reduce your monthly premium. If you qualify for cost-sharing reductions, you can get those savings only with a Silver plan.
Your doctors and prescriptions. Metal level doesn't determine a plan's provider network or drug coverage. Before enrolling, check whether your preferred doctors, hospitals, and prescriptions are covered.
Your total annual costs. A plan with a lower monthly premium isn't necessarily the least expensive option overall. Compare premium rates and potential out-of-pocket costs based on how much healthcare you expect to use.

Does your employer offer you an HRA?

If your employer offers a stand-alone health reimbursement arrangement (HRA) — such as a CHOICE Arrangement, formerly called an individual coverage HRA (ICHRA), or a qualified small employer HRA (QSEHRA) — they can reimburse you for your qualified individual health insurance premiums.

HRAs are becoming more popular among employers as an alternative to traditional group health insurance. How an HRA works is simple: employers provide their employees with a tax-free monthly allowance to buy individual health insurance coverage on a public or private exchange. Then, they reimburse employees tax-free for their plans’ monthly premium.

With an HRA, your employer can design your benefit to also reimburse you for qualifying medical expenses, such as:

Primary care visits
Care for medical emergencies
Prescription drugs
Over-the-counter medication

If you have an HRA, compare individual health insurance plans based on your health needs, budget, preferred providers, and prescriptions. And if your HRA covers premiums and out-of-pocket medical costs, check your employer's plan documents for details about which expenses are eligible.

Wondering what plans others with an HRA pick? Remodel Health’s 2026 National ICHRA Report, which examined data from PeopleKeep and Remodel Health CHOICE Arrangement customers, found that 34.6% of members chose a Silver plan, followed by 31.6% choosing Bronze plans, and 31.1% selecting Gold plans. Just 2.6% of members chose a Platinum plan.

Conclusion

Choosing the right metal tier depends mainly on two factors: your health and your budget. If you need significant medical care or medications, a higher-tier plan is a great choice if the premium fits your budget. If you're generally healthy and don't need much healthcare, you can pay less with a Silver or Bronze plan.

The marketplace offers tools to compare plan options and help you decide what is best for you. With premium tax credits and cost-sharing subsidies (not available to those with an affordable CHOICE Arrangement or QSEHRA), you may even be able to secure a lower monthly premium. Ultimately, having health insurance is crucial for managing unexpected medical bills if you have an accident or become ill.

This article was originally published on August 29, 2013. It was last updated on October 13, 2026.

References

Frequently asked questions

The four ACA metal levels describe how health care costs are typically divided between the plan and the plan holder. Bronze plans have an average actuarial value of 60%, Silver 70%, Gold 80%, and Platinum 90%.

Neither plan is better for everyone. Bronze policies generally have lower premiums and higher out-of-pocket costs, while Silver plans generally have higher premiums and lower cost-sharing. Silver may be especially beneficial if you qualify for cost-sharing reductions (CSRs).

A Gold plan may be worth considering if you expect to use healthcare frequently and prefer paying a higher monthly premium in exchange for lower costs when receiving care. Compare the plan's total annual costs before enrolling.

Someone who expects to use little health care may prefer Bronze plans because of their lower monthly premium rates. However, compare the deductible, out-of-pocket maximum, network, prescription coverage, and available financial assistance before choosing a plan.

No. Metal levels describe cost-sharing, not the quality of medical care. A Platinum plan generally pays a larger share of covered costs than a Bronze plan, but both must meet ACA requirements for Marketplace coverage.