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Health Care Reform:

Health Insurance & Affordable Care Act

Your Insurance Choices in a Marketplace: FAQ

A health insurance  Marketplace, also known as an Exchange, is a web site where you can shop for and compare  insurance plans in your state. Your state's Marketplace has tools to help you compare your choices and pick the best for your needs.

On a state Marketplace site, health plans are grouped by levels of coverage -- how much the plan will pay for your health care and what services are covered.

Each level is named after a type of metal:

Bronze plans offer the least coverage and platinum plans offer the most.

How do the bronze, silver, gold, and platinum levels differ?

The levels vary by the percentage of costs you have to pay on average toward the health care you receive.

Here are the percentages of health care costs you pay, on average, for each type of plan:

  • Bronze plan: 40%
  • Silver plan: 30%
  • Gold plan:  20%
  • Platinum plan: 10%

The way you pay your portion of these costs is in deductibles, copays, and coinsurance.

In general, the more you pay in monthly premiums, the less you’ll pay in out-of-pocket costs each time you go for a health care service or to pick up a prescription. A premium is what you each month to have insurance.

As an example, consider the differences in the bronze and platinum plans.

With a bronze plan: 

The amount you pay each time you see your doctor or get a prescription is the highest among the different plan levels. This is called having higher "out-of-pocket" costs. But, in a bronze plan, you also generally pay the lowest premium each month.

With a platinum plan: 

Compared to the other plan levels, you are likely to pay less each time you see your doctor or get a prescription. But in a platinum plan, you'll also pay the highest monthly premium.

How does coverage from a metal plan compare to my current insurance?

The bronze through platinum coverage levels are new. So you probably don't know how the benefits of the plan you use today compare to the benefits they offer. The coverage level you have now depends on how you bought your plan:

  • If you bought it from an employer, your coverage level is likely between a gold and platinum level.
  • If you bought it on your own, your coverage level is likely between a bronze and silver level.
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