Health Insurance

ACA Metal Tiers Explained: Bronze, Silver, Gold, and Platinum Plans Compared

Compare ACA metal tier plans by cost, coverage, and value. Learn how Bronze, Silver, Gold, and Platinum tiers work and which is best for you.

January 24, 2026

What Are ACA Metal Tiers?

When you shop for health insurance on the Affordable Care Act marketplace, every plan is organized into a metal tier: Bronze, Silver, Gold, or Platinum. The tier tells you how costs are split between you and the insurance company. It does not reflect the quality of care or the size of the provider network — a Bronze plan covers the same essential health benefits as a Platinum plan. The difference is entirely about money.

Each tier is defined by its actuarial value, which is the average percentage of total healthcare costs the plan pays for a standard population:

Bronze: 60% actuarial value — the plan pays about 60%, you pay about 40%
Silver: 70% actuarial value — the plan pays about 70%, you pay about 30%
Gold: 80% actuarial value — the plan pays about 80%, you pay about 20%
Platinum: 90% actuarial value — the plan pays about 90%, you pay about 10%

The higher the metal tier, the more you pay in monthly premiums but the less you pay when you actually receive care. The lower the tier, the less your premium costs but the more you are responsible for when you visit the doctor, fill a prescription, or have a procedure.

Bronze Plans: Lowest Premiums, Highest Out-of-Pocket Costs

Bronze plans have the lowest monthly premiums of any metal tier, making them appealing if your primary goal is to keep monthly costs as low as possible. In exchange, you take on significantly higher out-of-pocket costs when you use healthcare services.

Typical Bronze plan costs:

Average monthly premium: $350 to $450 (before subsidies)
Typical annual deductible: $6,000 to $8,000
Out-of-pocket maximum: up to $9,200 for individuals in 2026
Primary care copay: often $30 to $50 for the first few visits, then subject to deductible

Most Bronze plans will not pay for anything beyond preventive care until you have met the full deductible. That means if you have a $7,000 deductible and need an MRI or a specialist visit, you pay the full cost out of pocket until you hit that $7,000 threshold.

Best for: Young, healthy individuals who rarely need medical care beyond annual checkups and want the lowest possible monthly payment. Also a solid choice for anyone who wants catastrophic protection — insurance against worst-case scenarios like a serious accident or unexpected diagnosis — without paying high premiums every month.

Silver Plans: The Most Popular Tier — and for Good Reason

Silver plans sit in the middle of the metal tier spectrum and are the most widely enrolled tier on the ACA marketplace. There are two reasons Silver stands out from every other tier.

Reason 1: Premium tax credits are benchmarked to Silver. The government calculates your subsidy based on the cost of the second-lowest-cost Silver plan in your area. This means Silver plans tend to be the most affordable after credits are applied.

Reason 2: Silver is the only tier eligible for cost-sharing reductions (CSRs). If your household income falls between 100% and 250% of the federal poverty level, choosing a Silver plan unlocks additional subsidies that lower your deductible, copays, and out-of-pocket maximum. These savings are only available on Silver — you cannot get them on Bronze, Gold, or Platinum.

How cost-sharing reductions transform a Silver plan:

Income 100% to 150% FPL: Actuarial value boosted to approximately 94%. Deductibles as low as $0 to $75. Out-of-pocket maximum around $1,300. This is effectively better than a Platinum plan at a Silver-tier premium.
Income 150% to 200% FPL: Actuarial value boosted to approximately 87%. Deductibles around $500 to $1,500. Out-of-pocket maximum around $2,000 to $3,500.
Income 200% to 250% FPL: Actuarial value boosted to approximately 73%. More modest reductions, but still meaningfully lower deductibles and out-of-pocket maximums than a standard Silver plan.

Typical standard Silver plan costs (without CSRs):

Average monthly premium: $450 to $575 (before subsidies)
Typical annual deductible: $4,000 to $6,000
Out-of-pocket maximum: $7,000 to $9,200

Best for: Most marketplace shoppers, especially those with low to moderate incomes who qualify for CSRs. If you qualify for cost-sharing reductions and choose any other tier, you are leaving significant savings on the table.

Gold Plans: Higher Premiums, Lower Costs at the Doctor

Gold plans charge higher monthly premiums but reward you with substantially lower costs every time you use healthcare. Deductibles are typically in the $1,000 to $2,500 range — a fraction of what you would face on a Bronze or standard Silver plan — and copays for doctor visits and prescriptions are predictably lower.

Typical Gold plan costs:

Average monthly premium: $525 to $675 (before subsidies)
Typical annual deductible: $1,000 to $2,500
Out-of-pocket maximum: $6,000 to $8,500
Primary care copay: typically $20 to $40
Specialist copay: typically $40 to $80

Gold plans are particularly attractive for people who do not qualify for Silver-tier cost-sharing reductions but still use healthcare regularly. The math often works out: the extra premium you pay each month is offset — and then some — by the savings on deductibles, copays, and coinsurance throughout the year.

Best for: People who see doctors frequently, manage chronic conditions, or take multiple prescription medications. Also a strong choice for anyone planning a surgery or medical procedure in the coming year.

Platinum Plans: Maximum Coverage, Minimum Surprises

Platinum plans have the highest premiums on the marketplace but the lowest out-of-pocket costs. Deductibles are often $0 or close to it, and copays for most services are minimal. If you use a lot of healthcare, Platinum plans offer the most predictable and lowest total annual cost.

Typical Platinum plan costs:

Average monthly premium: $650 to $850 (before subsidies)
Typical annual deductible: $0 to $500
Out-of-pocket maximum: $2,000 to $4,500
Primary care copay: typically $10 to $25

Important: Platinum plans are not available in every market. Availability varies by state and county, and fewer insurers offer them compared to Bronze, Silver, and Gold. If a Platinum plan is available in your area and you have significant healthcare needs, it is worth comparing the total annual cost against a Gold plan.

Best for: People with high, predictable healthcare expenses — such as those managing multiple chronic conditions, undergoing regular treatments, or taking specialty medications. If you know you will spend heavily on care throughout the year, Platinum minimizes your financial exposure.

Catastrophic Plans: A Special Option for Under 30

Outside the four metal tiers, the ACA also offers Catastrophic plans. These are high-deductible, low-premium plans designed to protect against worst-case medical emergencies while keeping monthly costs as low as possible.

Who can enroll:

Individuals under age 30
People of any age who qualify for a hardship or affordability exemption

What Catastrophic plans cover:

Three primary care visits per year before the deductible
Free preventive services (the same as all ACA plans)
Full essential health benefits after the deductible is met

The deductible on a Catastrophic plan equals the annual out-of-pocket maximum — $9,200 for an individual in 2026. You pay for nearly everything out of pocket until you reach that threshold. After that, the plan covers 100% of covered services for the rest of the year.

Key limitation: Catastrophic plans are not eligible for premium tax credits. You pay the full premium regardless of your income. For many young adults who qualify for subsidies, a subsidized Bronze or Silver plan may actually cost less per month than an unsubsidized Catastrophic plan.

Comparing Premiums, Deductibles, and Out-of-Pocket Costs

Understanding the relationship between premiums and cost-sharing is the key to choosing the right tier. Here is how the numbers compare across tiers for a typical individual plan in 2026 (national averages, before subsidies):

Bronze: ~$400/month premium, ~$7,000 deductible, ~$9,200 out-of-pocket max
Silver: ~$510/month premium, ~$5,000 deductible, ~$8,500 out-of-pocket max
Gold: ~$600/month premium, ~$1,500 deductible, ~$7,500 out-of-pocket max
Platinum: ~$750/month premium, ~$200 deductible, ~$3,000 out-of-pocket max

These numbers shift dramatically once subsidies are applied. The majority of marketplace enrollees receive premium tax credits that reduce their effective monthly premium to well under $100 — and in many cases to $0 for Bronze plans.

Real-World Cost Scenarios: Which Tier Saves You the Most?

Premiums alone do not tell the whole story. To find the cheapest tier for your situation, you need to estimate your total annual cost: 12 months of premiums plus your expected out-of-pocket spending. Here are three common scenarios.

Scenario 1: Healthy adult, minimal healthcare use

A 28-year-old who visits the doctor once a year for an annual checkup and rarely needs prescriptions. Annual healthcare spending beyond preventive care: approximately $200.

Bronze total: $400/month x 12 = $4,800 in premiums + $200 out-of-pocket = $5,000
Gold total: $600/month x 12 = $7,200 in premiums + $100 out-of-pocket = $7,300

Winner: Bronze. The lower premium saves $2,300 per year because this person barely uses healthcare beyond free preventive services.

Scenario 2: Moderate healthcare use with ongoing prescriptions

A 45-year-old who manages high blood pressure, sees a specialist twice a year, and fills monthly prescriptions. Expected annual out-of-pocket healthcare spending before the deductible: approximately $4,500.

Bronze total: $4,800 premiums + $4,500 out-of-pocket = $9,300
Gold total: $7,200 premiums + $1,800 out-of-pocket = $9,000

Winner: Gold. Despite higher premiums, the Gold plan's lower deductible and copays result in $300 less spent overall. The savings increase further if healthcare spending exceeds the estimate.

Scenario 3: High healthcare use, planned surgery

A 55-year-old planning a knee replacement who also takes specialty medications. Expected to hit the plan's out-of-pocket maximum.

Bronze total: $4,800 premiums + $9,200 out-of-pocket max = $14,000
Gold total: $7,200 premiums + $7,500 out-of-pocket max = $14,700
Platinum total: $9,000 premiums + $3,000 out-of-pocket max = $12,000

Winner: Platinum. When you know you will max out your spending, the Platinum plan's low out-of-pocket maximum saves $2,000 compared to Bronze and $2,700 compared to Gold — despite its much higher premiums.

The Silver Plan Advantage: Cost-Sharing Reduction Subsidies

Cost-sharing reductions are one of the most valuable — and most overlooked — benefits available on the ACA marketplace. Unlike premium tax credits, which reduce your monthly bill, CSRs reduce what you pay at the point of care: lower deductibles, smaller copays, and a reduced out-of-pocket maximum.

CSRs are available only on Silver plans, and only if your household income is between 100% and 250% of the federal poverty level. You do not apply separately for CSRs — they are automatically applied when you choose a Silver plan and your income qualifies.

Here is why this matters so much: a person earning 140% FPL who chooses a Silver plan receives a CSR-enhanced version with approximately 94% actuarial value. That is better than a standard Platinum plan — at a Silver-level premium that is further reduced by premium tax credits. The same person choosing a Bronze or Gold plan would forfeit those cost-sharing reductions entirely, even though they still receive premium tax credits.

The bottom line on CSRs: If your income puts you in the CSR-eligible range, choosing Silver is almost always the right move. The enhanced plan you receive is dramatically more generous than the standard Silver plan you see listed.

How to Choose the Right Metal Tier for You

There is no single best metal tier — the right choice depends on your health, your income, and your tolerance for financial risk. Use these steps to narrow it down:

Check your income against FPL. If your household income is between 100% and 250% of the federal poverty level, start with Silver plans to take advantage of cost-sharing reductions. For 2026, 250% FPL is approximately $37,650 for an individual and $77,250 for a family of four.
Estimate your expected healthcare use. Review the past year. How many doctor visits did you have? What prescriptions do you take? Are you planning any procedures? If you rarely see a doctor, lean toward Bronze. If you use healthcare moderately to heavily, lean toward Gold or Platinum.
Calculate total annual cost for each tier. Do not just look at the premium. Add up 12 months of premiums (after subsidies) plus your estimated deductible, copays, and coinsurance. The cheapest premium is not always the cheapest plan.
Consider the worst-case scenario. Ask yourself: if I had an unexpected hospitalization or emergency, could I afford to pay up to the out-of-pocket maximum? If a $9,200 bill would be financially devastating, a Gold or Platinum plan with a lower maximum provides more protection.
Verify your doctors and medications. Provider networks and drug formularies vary across plans within the same tier. Before finalizing, confirm that your preferred doctors are in-network and your medications are covered at an acceptable cost tier.
Reassess every year. Plans change annually. Premiums rise or fall, networks shift, and formularies update. What was the best plan last year may not be the best plan this year. Always compare options during open enrollment.

The Bottom Line

ACA metal tiers exist to give you a clear framework for comparing health insurance plans. Bronze is cheapest month to month but most expensive when you need care. Platinum is the reverse. Silver occupies a unique position because it is the only tier eligible for cost-sharing reductions — making it the best value for millions of low- and moderate-income Americans.

The right tier is the one where your total annual cost — premiums plus out-of-pocket spending — is lowest for your expected level of healthcare use. Do not choose based on the premium alone. A plan that saves you $100 a month in premiums but costs you $3,000 more in deductibles is not a bargain.

Take 30 minutes during open enrollment to run the numbers. Use the cost estimator tools on HealthCare.gov or your state exchange, check your doctors and medications, and factor in any subsidies you qualify for. That small investment of time can save you thousands of dollars over the course of the year.

Need Affordable Health Insurance?

See if you qualify for subsidies and compare marketplace plans — free, no obligation.

See Health Insurance Options

Sources

Frequently Asked Questions

What does actuarial value mean for ACA metal tiers?

Actuarial value is the average percentage of total healthcare costs a plan pays for a standard population. A Bronze plan with 60% actuarial value means the insurer covers about 60% of costs on average and you pay about 40% through deductibles, copays, and coinsurance. It does not mean you personally will pay exactly 40% — your actual costs depend on how much healthcare you use. Someone who rarely sees a doctor may pay far less, while someone with a major surgery could hit the out-of-pocket maximum.

Why is the Silver plan considered the best value on the ACA marketplace?

Silver is the only metal tier eligible for cost-sharing reductions, which are additional subsidies that lower your deductible, copays, and out-of-pocket maximum if your income is between 100% and 250% of the federal poverty level. A CSR-enhanced Silver plan can function like a Gold or even Platinum plan at a fraction of the cost. Silver is also the benchmark tier used to calculate premium tax credits, which means subsidies are designed to make Silver plans especially affordable. If you qualify for CSRs, choosing any other tier means forfeiting those extra savings.

Can I enroll in a Catastrophic plan if I am over 30?

Generally, Catastrophic plans are only available to people under age 30. However, there is an exception: if you qualify for a hardship exemption or an affordability exemption — meaning you cannot find an affordable plan that costs less than approximately 8.5% of your household income — you may be eligible regardless of age. You apply for the exemption through the marketplace or claim it on your tax return. Catastrophic plans are not eligible for premium tax credits, so you would pay the full premium.

Do all metal tiers cover the same medical services?

Yes. Every ACA-compliant plan, regardless of metal tier, must cover the same ten categories of essential health benefits: ambulatory care, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, lab services, preventive care, and pediatric services including dental and vision. The difference between tiers is not what is covered but how the costs are shared between you and the insurer. Higher tiers charge higher premiums but cover a larger share of your costs when you use care.

Is it better to pay a higher premium or a higher deductible?

It depends on how much healthcare you expect to use. If you are generally healthy and mostly need preventive care, a lower-premium Bronze plan saves money because you are unlikely to reach the deductible. If you have ongoing conditions, take expensive medications, or anticipate a major procedure, a Gold or Platinum plan with higher premiums but lower deductibles and copays will usually cost less in total. The best approach is to estimate your total annual cost under each tier — add up 12 months of premiums plus your expected out-of-pocket spending — and compare the totals.

What happens if I pick the wrong metal tier?

Outside of open enrollment, you generally cannot switch metal tiers unless you experience a qualifying life event that triggers a Special Enrollment Period. If you realize mid-year that your plan does not fit your needs, you can make changes during the next annual open enrollment period, which typically runs from November 1 through January 15 on the federal marketplace. To avoid picking the wrong tier, carefully estimate your healthcare usage before enrolling and review your plan options every year, since premiums, networks, and formularies change annually.

ACAmetal tiersBronze planSilver planGold planPlatinum planhealth insuranceactuarial valuecost-sharing reductionpremium tax creditHealthCare.gov