Anyone who has purchased health insurance knows that understanding the difference from one plan to the next can be very confusing. Plans offer different benefits, different levels of deductibles and co-pays, in network vs. out-of-network care, etc.
In order to make it easier for consumers to understand and compare insurance options, the Affordable Care Act (ACA) sets up four (4) levels of insurance: bronze, silver, gold, and platinum.
All four types of plans must include coverage for the essential health benefits. Insurance companies whose plans are sold in the exchange must offer at least a silver and a gold plan.
On a very basic level, what determines a plan’s category is the degree of cost-sharing for the coverage — i.e., what portion of a health care expense is paid out-of-pocket by the individual vs. covered by the insurance. Bronze plans will have the least amount of coverage and the greatest out-of-pocket expenses, while platinum plans will have the most generous coverage and the least out-of-pocket expense.
We could give you lots of numeric formulas and details about the different levels of insurance, but we don’t want to run the risk of scaring you away from our site! If you’re dying to understand it more in-depth, please give us a call!