Covered California Series: Silver and Bronze Plans Explained

November 18, 2013

Health care laws are changing. As of Jan. 1, 2014, most Americans will be required to be insured under a qualified health care plan or pay a fine. In response to this new law, online marketplaces called “exchanges” have been created to make finding and purchasing health insurance easier. In California, the marketplace is known as Covered California.

Designed to look and act like a travel website, Covered California allows users to compare health insurance prices in one place and gives information about government subsidies and tax credits you may qualify for. All plans fall into one of four “metallic” tiers: platinum, gold, silver or bronze. These tiers represent the level of coverage you’ll receive, as well as the amount you can expect to pay for insurance.

Silver and Bronze Plans

Silver and bronze represent the lowest tiers of available plans, and are best suited for those who have no health complications and don’t expect to use many healthcare services. It is important to note that no matter which tier you choose, the same essential health benefits are covered under all plans, and you cannot be turned away for a pre-existing condition. All plans also carry a yearly maximum out-of-pocket amount of $6,350 for an individual and $12,700 for families.

That said, not all plans are created equal. While silver and bronze plans carry the lowest monthly premium (the amount you pay each month whether or not you visit a doctor), they also have higher deductibles and copays than platinum and gold plans.

A silver plan carries a $2,000 deductible, while a bronze plan deductible is $5,000. Silver and bronze plans can be counted on to pay 70% and 60% of your health care costs respectively.

Which Plan is Best for Me?

Younger adults and families might feel confident choosing a bronze or silver plan to save on monthly bills. However, it’s important to remember that your higher deductible will need to be paid before insurance will kick in, should you need care. An accident or illness can quickly leave the underinsured in financial trouble.

Those with chronic health problems or expensive monthly medications should probably stay away from the bronze and silver tier plans and consider a platinum or gold option instead. Although less expensive in the short term, the higher deductibles, coinsurance, and copays can add up significantly over time.

Terpening Insurance is here to help you with all of your health insurance questions. To learn more about Covered California, we’ve put together a comprehensive guideContact us right away, and we’ll work together to make sure you get the best coverage available at a price you can afford.

Post author Loren Pleet