Health Insurance Plans & Levels of Coverage

In order to make it even easier to find the plan that’s right for you, health insurance plans are standardized into five categories: gold, silver, bronze and catastrophic.

This sample chart represents the levels of coverage, what plans pay and what enrollees pay, on average.

Tier

Monthly Cost

AV

After Deductible Cost to Consumer

Gold More Expensive 80% 20% of Medical Costs
Silver Base 70% 30% of Medical Costs
Bronze Less Expensive 60% 40% of Medical Costs
Catastrophic Least Expensive <60% >40% of Medical Costs

AV (actuarial value) is the average cost paid by the insurance company for your medical bills, such as prescriptions and doctor’s visits. With the bronze plan, for example, the insurance company pays 60% of the cost and the individual pays 40%. The 40% you would be responsible for is made up of deductibles and co-payments based on the type of services received.

A deductible is the amount of money you’d need to pay out of pocket before certain benefits from the health policy can be used. Learn more about deductibles here. A copayment is the amount of money you have to pay the day of the service to see your doctor or get your prescription. Learn more about co-payments here.

Different plans work better for different people. Learn more about what plan might be right for you.