Understanding the Different Metal Tiers in Covered California Plans

Shopping for health insurance is stressful enough without having to decode all the health plan jargon. For example, what does silver and platinum have to do with your health? Where does bronze come in? It’s all confusing. 

When shopping for health insurance on the ACA marketplace, you’ll probably notice various Covered California “metal” tiers attached to each plan. The metal category you choose can have a significant impact on how much you pay for both your monthly premiums and your ongoing healthcare costs. Once you learn about each tier, you can use the metal system as a helpful guide to balance your budget with your coverage needs. 

Keep reading to let a knowledgeable Freeway agent help you make the right choice. 

What Are the Different Metal Tiers in Covered California? Covered California Metal Tiers Explained 

Health insurance plans in California fall into four metal tiers that describe the price and the level of coverage of marketplace health plans: bronze, silver, gold, and platinum. As the value of the metals increases, the price and quality of the policies also go up. Bronze is the cheapest and provides a basic level of coverage, while platinum is the most expensive and covers the highest percentage of your healthcare costs. 

Each of the Covered California plans on the marketplace falls into one of these four categories to make the shopping experience easier. Prices and coverage can vary slightly within the tiers, but they’re a helpful guide for finding a plan in your budget that also offers enough support for you and your family. Here are the main health insurance tiers explained. 

Bronze Plans: The Basics and Benefits 

Bronze is the cheapest option of the Covered California metal tiers. In general, a bronze Covered California plan will cover about 60% of your medical costs, while you pay for the remaining 40%. They also have the lowest premiums available in the marketplace. If you’re generally healthy and mainly get preventive care, bronze can be a great choice. You’ll get the peace of mind of having coverage for an emergency and any other health needs, while also keeping your monthly expenses low. 

Silver Plans: A Balance of Cost and Coverage 

With a silver Covered California plan, the insurer covers about 70% of costs, and you cover 30%. You’ll have lower copays than some plans, but additional expenses compared to someone on a bronze plan, so you’ll pay more monthly in exchange for lower out-of-pocket costs. This strikes a good balance for people who may have more ongoing health needs or regular medical appointments. 

Silver plans can also provide additional benefits from cost-saving reductions. Cost-saving reduction programs only apply to silver plans, so choosing a silver tier option could actually be more affordable than a bronze option in some cases. 

Gold Plans: Higher Coverage for Higher Premiums 

Gold plans increase the insurer’s responsibility to about 80% of costs, so you only have to pay 20%. These plans often have low copays and deductibles compared to lower tiers. If you have more complex medical needs, getting a gold Covered California plan can be an effective way to keep medical costs low. Although the premiums are higher, you’ll be able to get more care without paying significant out-of-pocket costs. 

Platinum Plans: Top Coverage with a Higher Price Tag 

The platinum Covered California plan options are designed to give you the highest level of coverage available, with the insurer paying 90% of your medical costs. They’re ideal for people who require significant ongoing medical care. They have the highest premiums, but a higher monthly premium can be well worth the extra safety net if you have expensive treatments or regular meetings with specialists. 

How To Choose the Right Covered California Plan for You 

So how do you know which of the Covered California metal tiers is right for you? Choosing the right Covered California plan is all about comparing all of your insurance options. It’s especially important to compare your out-of-pocket costs with your recurring monthly premium.  

Did you know that one out of five California residents can get very low-cost or free health insurance? Talking to a Freeway agent who specializes in health insurance can help you find out if you do. This is a free service, so call us at 877-423-1508. 

Matching Your Healthcare Needs with the Right Tier 

To optimize your coverage, it can be helpful to calculate your potential costs for each metal level. See how often you used different medical services over the past year, then add up your various copays and coinsurance expenses. Add this number to your premium to get an estimate of your total expenses, then make your choice from there. You might also decide it’s worth it to get a higher-level plan for the extra peace of mind if unexpected health issues pop up. 

How Premiums and Deductibles Vary Across Tiers 

In general, platinum plans will have the lowest deductibles and highest premiums, while bronze plans will be at the other end of the spectrum. Certain gold and platinum plans will not have any deductible at all, and will also have lower out-of-pocket maximums. However, insurers can set varying deductibles and premiums, so it’s important to look at the details of each individual policy. 

Is a Lower-Premium, Higher-Deductible Plan Right for You? 

Bronze plans are appealing options because they have the lowest premiums. However, they usually have higher deductibles, which means you’ll have to spend more before your benefits kick in. These plans work well for people who want insurance just in case, but don’t have many expected health expenses. If you mainly get routine care and checkups, a high-deductible plan could be a good way to save money on your policy each month. 

How To Make Sure You’re Getting the Coverage You Need 

It can be hard to decide exactly which of the Covered California metal tiers makes sense for your situation. You can talk over your options with an insurance agent to help compare costs and find a plan that works for you. You can also use marketplace tools to make sure your preferred providers are in network with your chosen plan. 

Get Help from Freeway Choosing the Right Covered California Plan 

The metal tier system is a helpful way to pick out a policy based on the level of coverage that makes sense for your health and finances. Knowing whether a plan is bronze, platinum, or in between can help you make the smartest decision for your lifestyle. 

Regardless of which tier you choose, Freeway Insurance is the best place to help you set up your coverage for the next year. A knowledgeable Freeway agent will help explain the metal tier health insurance, so you’ll be able to navigate the marketplace with ease and choose a plan that covers all of your needs. We offer a free service to help you sign up for the right plan. Just call us at 877-423-1508. 

FAQs 

Want to know more about how marketplace plans work? Check out this Q&A. 

Can I Change My Covered California Plan After I Enroll? 

You can change your plan during open enrollment, but after your coverage starts, you can’t change it until the next enrollment period. However, you can cancel your coverage at any time. 

Are There Subsidies Available for Covered California Health Plans? 

There are subsidies available for Covered California plans. This includes cost-sharing adjustments for silver plans and ACA tax credits, which can apply to plans of any level. 

Can I Add My Family Members to My Covered California Plan? 

Yes! You can choose between individual and family marketplace plans.