Marketplace health plans are sorted into metal categories: bronze, silver, gold and platinum, with catastrophic plans as a fifth category available to some people.
The categories describe how you and the plan split costs. They say nothing about quality of care, network size, or how well the insurer handles claims.
Actuarial value is the whole idea
Each metal level corresponds to a target actuarial value, which is the share of covered medical costs a plan is expected to pay for a standard population over a year.
| Metal level | Target actuarial value | Plan pays, on average | You pay, on average |
|---|---|---|---|
| Bronze | 60 percent | About 60 percent | About 40 percent |
| Silver | 70 percent | About 70 percent | About 30 percent |
| Gold | 80 percent | About 80 percent | About 20 percent |
| Platinum | 90 percent | About 90 percent | About 10 percent |
Three points about that table are easy to get wrong.
It describes a population, not you. Actuarial value is calculated across a standard population using a federal calculator. Your own share in a given year depends entirely on what care you use. Someone on a bronze plan who never sees a doctor pays 100 percent of nothing. Someone on the same plan who has a hospitalization may hit the out-of-pocket maximum in a single admission.
It excludes premiums. Actuarial value measures the split on covered medical costs. What you pay monthly to hold the plan is separate.
Plans do not have to hit the number exactly. Federal rules allow a de minimis variation around each target, generally minus two to plus two percentage points for individual and small group plans, with a wider upper band for expanded bronze plans. Rules in this area have been the subject of recent rulemaking and litigation, so the precise allowable range in a given plan year is worth confirming on HealthCare.gov or with your state exchange.
Higher tier does not mean better coverage
Every marketplace plan at every metal level must cover the same ten essential health benefits, including preventive services. That is covered in essential health benefits and preventive care.
What changes across tiers is the cost sharing: the deductible, the copays, the coinsurance and the out-of-pocket maximum. As actuarial value rises, deductibles generally fall and the monthly premium generally rises. A gold plan is not a plan that covers more conditions. It is a plan that pays a larger share of the same covered conditions, in exchange for a higher monthly cost.
The mechanics of that cost sharing are covered in deductible, copay, coinsurance and out-of-pocket max.
Why silver is the tier that behaves differently
Silver plans carry a feature no other tier has. Cost-sharing reductions are available only on silver plans.
Cost-sharing reductions lower the deductible, coinsurance and out-of-pocket maximum for enrollees with household income between 100 and 250 percent of the federal poverty level. HHS sets reduced maximum annual limitations on cost sharing for these silver plan variants each year, with the largest reduction applying at the lowest income band and a smaller reduction in the band above it.
The practical effect: an eligible enrollee who chooses silver can end up with a plan whose actual cost sharing is richer than a standard gold plan, while an eligible enrollee who chooses bronze forfeits that benefit entirely.
Premium tax credits, by contrast, can be applied to a plan at any metal level. Only the cost-sharing reductions are restricted to silver. Both are covered in marketplace subsidies explained.
Whether cost-sharing reductions are worth reaching for depends on your household income relative to the federal poverty level, which is a calculation a licensed agent or your state exchange can run for your situation.
Catastrophic plans
Catastrophic plans are a separate category with restricted eligibility. They are generally available only to people under 30, or to people 30 and over who qualify for a hardship or affordability exemption.
They are not required to meet a minimum actuarial value target, except that their value must be lower than bronze. They still cover the essential health benefits and preventive services, but with cost sharing designed to leave most routine costs with the enrollee until a high threshold is reached.
Premium tax credits generally cannot be applied to a catastrophic plan, which is a meaningful consideration for anyone who would otherwise qualify for one.
Bronze plans and health savings accounts
Under changes taking effect January 1, 2026, bronze and catastrophic exchange plans are treated as compatible with a health savings account regardless of whether they satisfy the general high deductible health plan definition. That widened the set of marketplace plans that can be paired with an HSA. The account rules themselves are covered in HSAs, FSAs and high deductible health plans.
How to actually choose a tier
The tier is one input among several, and picking on tier alone is how people end up in plans that fit poorly.
- Start with your income relative to the federal poverty level. If cost-sharing reductions are available to you, silver deserves a serious look before anything else.
- Look at the out-of-pocket maximum, not just the deductible. That number is your worst case for in-network care, and it is often the most decision-relevant figure on the page.
- Check the network before the tier. A gold plan that excludes your physician can serve you worse than a bronze plan that includes them. Network types are covered in HMO, PPO, EPO and POS plans explained.
- Check the drug formulary if you take regular prescriptions, since drug tiers work independently of metal tiers.
- Think about the bad year, not the average year. The question is not only what you expect to spend but what you could absorb if something unexpected happened.
Metal levels, cost sharing and plan availability vary by insurer, by plan and by state, and rules in this area have changed more than once in recent years. For your own situation, HealthCare.gov, your state exchange, a licensed agent, or your state Department of Insurance are the sources that can give a definitive answer.
You can request health insurance quotes to get connected with licensed carriers and agents offering plans in your area.