Affordable Care Act Metal Levels

9
Sep

What are these metal levels?

 

The Affordable Care Act (ObamaCare) introduced a lot of new terms into the health insurance dialog. In an effort to make health insurance easier for consumers to understand, every plan sold through the Federally Facilitated Marketplace has a metal designation of bronze, silver, gold or bronze.

But what do these mean?

The metal type indicates the relative richness of the plan. Put another way, the metal designation groups together plans with similar cost sharing characteristics. For every plan, there is an established actuarial value.

Actuarial Value

The percentage of total average costs for covered benefits that a plan will cover. For example, if a plan has an actuarial value of 70%, on average, you would be responsible for 30% of the costs of all covered benefits. However, you could be responsible for a higher or lower percentage of the total costs of covered services for the year, depending on your actual health care needs and the terms of your insurance policy.

Source:            https://www.healthcare.gov/glossary/actuarial-value/

With this in mind, the metals are broken out like this:

Platinum          90% of Actuarial Value

Gold                 80% of Actuarial Value

Silver               70% of Actuarial Value

Bronze             60% of Actuarial Value

Source:            https://www.healthcare.gov/glossary/health-plan-categories/

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