Silver Loading Explained: How to Get a Gold Plan at Silver Prices

What Is Silver Loading?

If you have ever shopped for health insurance on the ACA marketplace and noticed that silver plans seem unusually expensive compared to gold plans, you are not imagining things. The explanation is a pricing phenomenon called silver loading, and understanding it could save you hundreds or even thousands of dollars a year on health insurance.

Silver loading is the practice of insurance companies adding the unfunded cost of cost-sharing reduction (CSR) subsidies exclusively to the premiums of silver-tier plans. The result is that silver plan premiums are artificially inflated — sometimes by 10% to 25% or more — compared to where they would be if the federal government were still directly funding CSR payments. This single pricing quirk ripples through the entire subsidy calculation and creates an opportunity for savvy shoppers to get gold-level coverage at silver-level prices.

To understand why silver loading exists and how to take advantage of it, you need to understand three things: what cost-sharing reductions are, how ACA subsidies are calculated, and why insurers add CSR costs to silver plans only.

The Origin of Silver Loading: CSR Payments and What Happened in 2017

The Affordable Care Act created cost-sharing reductions to help low-income enrollees afford care when they use it. CSRs lower deductibles, copays, and out-of-pocket maximums on silver plans for people earning between 100% and 250% of the federal poverty level. Under the original design, the federal government reimbursed insurance companies directly for the cost of providing these richer benefits.

In October 2017, the federal government stopped making those direct CSR reimbursement payments to insurers. Critically, insurers were still legally required to provide the cost-sharing reductions to eligible enrollees — they just were no longer being paid for them. Insurance companies had to recover billions of dollars in CSR costs somehow, and they had to build that cost into their premiums.

State regulators stepped in and most directed or allowed insurers to add the CSR costs exclusively to silver plan premiums — the only tier where CSRs apply. This approach became known as silver loading. It was a deliberate choice: by concentrating the cost increase on silver plans, regulators ensured the maximum benefit would flow back to subsidized consumers through higher premium tax credits.

How ACA Subsidies Are Calculated — and Why Silver Loading Matters

To see why silver loading is so powerful, you need to understand how premium tax credits work. Your ACA subsidy is calculated using a simple formula:

Premium Tax Credit = Cost of the second-lowest-cost silver plan (the benchmark) minus your expected contribution (a percentage of your household income)

The benchmark plan is always a silver plan. When silver loading inflates silver premiums, the benchmark price goes up. When the benchmark price goes up, your premium tax credit goes up by the same amount. The subsidy increase applies regardless of which metal tier you actually choose — bronze, silver, or gold.

Here is the key insight: gold plan premiums are not silver-loaded. They are priced based on their actual expected costs. So you receive a subsidy that is inflated by silver loading, but you apply it to a gold plan whose price has not been inflated. The result is that gold plans become remarkably affordable after subsidies — often cheaper than the silver plans that generated the larger subsidy in the first place.

Why Gold Plans Can Be Cheaper Than Silver After Subsidies

Let us walk through a concrete example to see how silver loading creates the gold-cheaper-than-silver situation.

Imagine a 40-year-old individual earning $45,000 a year — approximately 275% of the federal poverty level in 2026. In her area, the plans available before subsidies are priced as follows:

• Second-lowest-cost silver plan (benchmark): $620/month (silver-loaded — would be ~$510 without loading)
• Lowest-cost gold plan: $580/month (not silver-loaded)

At 275% FPL, this person's expected contribution is approximately $320 per month. Her premium tax credit equals the benchmark minus her contribution: $620 minus $320 equals a $300 monthly subsidy.

Now apply that $300 subsidy to each plan:

• Silver plan after subsidy: $620 - $300 = $320/month
• Gold plan after subsidy: $580 - $300 = $280/month

The gold plan costs $40 less per month than the silver plan — a savings of $480 a year in premiums alone. But the real advantage is even bigger: the gold plan also has a lower deductible (typically $1,000 to $1,500 versus $4,000 to $6,000 on silver), lower copays, and a lower out-of-pocket maximum. You are paying less every month and getting better coverage.

Without silver loading, the benchmark silver plan would have been priced around $510, the subsidy would have been only $190, and the gold plan would have cost $390 per month after credits — making it noticeably more expensive than silver. Silver loading flipped the math entirely.

Who Benefits Most from Silver Loading

Silver loading does not benefit everyone equally. Your income level determines how much advantage you can extract from the pricing distortion.

Income 100% to 150% FPL: Stay on Silver

If your income is between 100% and 150% of the federal poverty level, you qualify for the highest tier of cost-sharing reductions. A CSR-enhanced silver plan at this income level has approximately 94% actuarial value — meaning the insurer covers 94% of average healthcare costs. That is better than a standard platinum plan. You should almost always choose silver in this range because the CSR benefits you would forfeit by switching to gold are worth far more than the premium savings from silver loading.

Income 150% to 200% FPL: Compare Carefully

At this income level you still qualify for meaningful cost-sharing reductions that boost silver plans to approximately 87% actuarial value. For people who use moderate to heavy amounts of healthcare, the CSR-enhanced silver plan may still beat gold. However, for relatively healthy individuals in this range, a gold plan could be cheaper overall after accounting for both premiums and out-of-pocket costs. Run the numbers both ways.

Income 200% to 400% FPL: The Silver Loading Sweet Spot

This is where silver loading delivers the most value. At incomes above 250% FPL you receive no cost-sharing reductions at all, so there is nothing to lose by leaving silver. Between 200% and 250% FPL the CSRs are modest (73% actuarial value versus the standard 70%). In this entire range your premium tax credit is boosted by the inflated silver benchmark, and you can apply that larger credit to a gold plan that has not been inflated. This is the income band where the "gold plan at silver prices" phenomenon is most pronounced. For the 2026 plan year, 400% FPL is approximately $60,240 for an individual and $123,600 for a family of four — and with the extended subsidy provisions, many people above 400% FPL also benefit. Learn more about how subsidies scale at different income levels in our guide to ACA premium tax credits.

Unsubsidized Shoppers: Avoid Silver Entirely

If your income is too high for subsidies or you purchase insurance off-marketplace, you do not benefit from silver loading at all — you only pay the inflated price. Unsubsidized shoppers should generally avoid silver plans and compare bronze and gold plans directly. The gold plan's full premium is based on actual costs, not silver-loaded costs, and often represents the best value for people who use healthcare regularly.

Step-by-Step: How to Find a Gold Plan at Silver Prices

Taking advantage of silver loading does not require any special applications or workarounds. You simply need to shop strategically on the marketplace. Follow these steps during open enrollment or a Special Enrollment Period.

1. Go to HealthCare.gov or your state marketplace and enter your household income. The system will calculate your estimated premium tax credit based on the silver-loaded benchmark plan in your area. You need this number before you can compare plans meaningfully.
2. View all available plans and sort by after-subsidy premium. Do not look at the full (pre-subsidy) price — it will be misleading. The after-subsidy price is what you actually pay each month. Compare silver and gold plans side by side.
3. Identify gold plans that cost the same as or less than silver plans after subsidies. In many markets you will find at least one gold plan that is cheaper than most silver plans after your tax credit is applied. This is the silver loading effect in action.
4. Compare total annual cost, not just premiums. Multiply the monthly after-subsidy premium by 12, then add your estimated out-of-pocket costs based on your expected healthcare use. The gold plan's lower deductible and copays often make its total annual cost significantly lower than silver, even if the premiums appear close.
5. Check the provider network and drug formulary. A cheaper gold plan only saves you money if your doctors are in-network and your prescriptions are covered. Verify both before enrolling.
6. Enroll in the gold plan and confirm your subsidy is applied. Your premium tax credit applies automatically to whichever plan you choose — you are not locked into silver to receive it.

Real-World Examples: Silver Loading in Action

The following scenarios illustrate how silver loading changes the math for different household types. All figures use representative 2026 plan-year pricing.

Example 1: Single adult, age 35, earning $38,000 (approximately 235% FPL)

• Benchmark silver plan: $595/month (silver-loaded)
• Expected contribution: approximately $240/month
• Premium tax credit: $355/month
• Silver plan after subsidy: $595 - $355 = $240/month (with $5,200 deductible, $8,500 out-of-pocket max)
• Gold plan after subsidy: $560 - $355 = $205/month (with $1,500 deductible, $7,000 out-of-pocket max)

Result: The gold plan saves $35 per month ($420 per year) in premiums while also offering a deductible that is $3,700 lower and an out-of-pocket max that is $1,500 lower. At every level of healthcare use, gold costs less than silver.

Example 2: Married couple, both age 50, earning $72,000 (approximately 295% FPL)

• Benchmark silver plan for two: $1,380/month (silver-loaded)
• Expected contribution: approximately $530/month
• Premium tax credit: $850/month
• Silver plan after subsidy: $1,380 - $850 = $530/month (with $10,000 family deductible)
• Gold plan after subsidy: $1,260 - $850 = $410/month (with $2,500 family deductible)

Result: The couple saves $120 per month ($1,440 per year) in premiums by choosing gold over silver, with a family deductible that is $7,500 lower. If either spouse needs a hospitalization or procedure, the gold plan's lower cost-sharing could save thousands more.

Example 3: Single parent with one child, earning $52,000 (approximately 265% FPL)

• Benchmark silver plan for family: $840/month (silver-loaded)
• Expected contribution: approximately $340/month
• Premium tax credit: $500/month
• Silver plan after subsidy: $840 - $500 = $340/month
• Gold plan after subsidy: $775 - $500 = $275/month

Result: The single parent saves $65 per month ($780 per year) in premiums by choosing gold, with substantially lower copays for pediatric visits, prescriptions, and specialist care. For a family with a child who needs regular checkups and potentially urgent care visits, the gold plan's lower cost-sharing adds significant additional value.

How to Compare Net-of-Subsidy Prices Across Tiers

The most important number when shopping for ACA coverage is not the sticker price of the plan — it is the net-of-subsidy price, also called the after-subsidy or effective premium. Understanding how to find and compare this number is essential, especially when silver loading distorts the sticker prices. For a broader look at premium ranges, see our guide on how much health insurance costs in 2026.

Here is a practical framework for comparing plans across tiers:

1. Start with the after-subsidy monthly premium. This is your guaranteed monthly expense regardless of healthcare use. Multiply by 12 to get your annual premium cost.
2. Estimate your out-of-pocket costs under each plan. Look at the deductible, copays for your typical services (primary care, specialists, prescriptions), and coinsurance rates. Use last year's healthcare utilization as a guide.
3. Calculate total annual cost for each plan. Add 12 months of after-subsidy premiums plus your estimated out-of-pocket spending. This is the number that matters most.
4. Check the worst-case scenario. Calculate 12 months of after-subsidy premiums plus the annual out-of-pocket maximum for each plan. This tells you the most you could possibly spend in a catastrophic year. Gold plans typically have a much lower worst-case total than silver plans.
5. Factor in non-price differences. Provider network size, specific doctor availability, drug formulary coverage, and plan ratings can all differ between silver and gold plans from the same insurer. A slightly more expensive gold plan with your preferred doctors in-network may be worth more than a cheaper gold plan without them.

Silver Loading and the Different Metal Tiers

Silver loading does not just affect the silver-versus-gold comparison. It changes the economics of every metal tier on the marketplace.

• Bronze plans: Silver loading increases your subsidy enough that many bronze plans become free or nearly free after credits. This is great for young, healthy people who want catastrophic protection at zero monthly cost. However, bronze plan deductibles are still very high ($6,000 to $8,000+), so you pay heavily when you actually use care.
• Silver plans: The silver-loaded premium is partially offset by the higher subsidy, but standard silver plans (without CSRs) end up being the worst value for many subsidized shoppers. The premium is inflated, the deductible is moderate to high ($4,000 to $6,000), and you could get better coverage for less by choosing gold.
• Gold plans: The biggest winners from silver loading. Gold premiums are not inflated, but your subsidy is. The result is lower after-subsidy premiums combined with significantly lower deductibles ($1,000 to $2,000) and copays. For moderate to heavy healthcare users, gold is often the best overall value.
• Platinum plans: Where available, platinum plans also benefit from the inflated subsidy. However, platinum premiums are already very high, so even with a boosted credit, the net premium may still be substantial. Platinum is worth considering if you have very high healthcare needs and a platinum plan is available in your market.

State Variations: Silver Loading Is Not Uniform

Not every state handles CSR costs the same way. The approach your state uses directly affects how much silver loading benefits you.

• Silver-only loading (most states): CSR costs are added exclusively to on-marketplace silver plans. This produces the strongest silver loading effect and the biggest subsidy boost. Gold plans benefit the most in these states.
• Broad loading (a few states): CSR costs are spread across all metal tiers on the marketplace. This increases premiums for bronze, silver, and gold plans alike, reducing the relative advantage of switching from silver to gold. Subsidies are still boosted because the benchmark silver plan is higher, but the gold plan's premium is also higher.
• Broad-based loading (rare): CSR costs are spread across all individual market plans, including off-marketplace plans. This dilutes the loading effect further and reduces the subsidy boost for marketplace shoppers.

If you live in a silver-only loading state — which is the vast majority of states — the gold-cheaper-than-silver dynamic will be most pronounced. In broad-loading states, the advantage may be smaller but can still exist depending on the specific plan pricing in your area.

Common Mistakes to Avoid

Many marketplace shoppers miss out on the silver loading advantage because of a few common errors.

• Assuming silver is always the best choice. Silver is the default recommendation for most marketplace guides, and for good reason — it is the only tier eligible for CSRs. But if your income is above 200% FPL, especially above 250% FPL, the CSR benefits are modest or nonexistent. In that case, defaulting to silver means paying an inflated premium for coverage that a gold plan beats on every metric.
• Comparing sticker prices instead of after-subsidy prices. A gold plan with a $600 sticker price may look more expensive than a silver plan at $595. But after a $350 subsidy, the gold plan costs $250 and the silver plan costs $245 — a negligible difference that disappears entirely when you factor in the gold plan's lower deductible and copays.
• Ignoring out-of-pocket costs entirely. The premium is only part of your total healthcare spending. A silver plan that costs $10 less per month but has a deductible $3,500 higher than a gold plan will cost you far more the moment you need an MRI, an ER visit, or a specialist appointment.
• Forgetting to re-shop every year. Silver loading amounts change annually as insurers adjust their pricing. The gold plan that beat silver this year may not beat it next year, or the gap may widen. Always compare plans fresh during each open enrollment period.

The Bottom Line

Silver loading is one of the most powerful — and least understood — dynamics in ACA marketplace shopping. Because insurers add the cost of unfunded CSR subsidies exclusively to silver plan premiums, the benchmark plan used to calculate your subsidy is inflated. That inflated subsidy can then be applied to a gold plan whose premium reflects actual costs, not silver-loaded costs. The result: gold plans that cost less than silver after subsidies, with lower deductibles, lower copays, and lower out-of-pocket maximums.

If your income is between 100% and 150% FPL, the strongest CSR enhancements make silver the clear winner. But if your income is between 150% and 400% FPL — or above 400% FPL with extended subsidy eligibility — you owe it to yourself to compare gold plans side by side with silver. In many markets, the gold plan is cheaper on every dimension: lower monthly premium after subsidies, lower deductible, lower copays, and lower maximum exposure.

The strategy is simple: log into the marketplace, enter your income, and compare the after-subsidy prices for silver and gold plans. Look at the full picture — premiums, deductibles, copays, and out-of-pocket maximums. If a gold plan costs the same or less than silver after your tax credit, you have found the silver loading sweet spot. Enroll in the gold plan, get better coverage, and keep more money in your pocket.