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12671: Exchange Plan Levels (ACA)


ACA

What plans are offered in the health insurance marketplace exchanges under the Affordable Care Act (ACA)?

There are 5 categories of coverage in the Marketplace. Plans in each category pay different amounts of the total costs of an average person’s care. This takes into account the plans' monthly premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums.  The actual percentage you’ll pay in total or per service will depend on the services you use during the year. The first 4 categories are referred to as the "metal levels."

  • Bronze: Your health plan pays 60% on average. You pay about 40%.
  • Silver: Your health plan pays 70% on average. You pay about 30%.
  • Gold: Your health plan pays 80% on average. You pay about 20%.
  • Platinum: Your health plan pays 90% on average. You pay about 10%.

The 5th category is Catastrophic: Catastrophic coverage plans pay less than 60% of the total average cost of care on average. They’re available only to people who are under 30 years old or have a hardship exemption.

Marketplace insurance categories


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