Quick answer: ACA Marketplace plans come in four metal tiers. On average, a Bronze plan pays about 60% of covered costs, Silver about 70%, Gold about 80% and Platinum about 90%, with you paying the rest through deductibles, copays and coinsurance. Lower tiers have lower premiums and higher costs when you get care. Silver is the only tier that offers cost-sharing reductions to lower-income enrollees, and since 2026 every Bronze and Catastrophic plan works with a health savings account. The metal name says nothing about the quality of care or the doctors in the network.
Shopping on HealthCare.gov or a state Marketplace means choosing a metal tier before almost anything else. Bronze, Silver, Gold and Platinum sound like quality grades, yet they describe something narrower: how the cost of covered care is split between you and the insurance company.
That split matters. Pick a tier that is too thin for the care you use and a single hospital stay can wipe out what you saved on premiums. Pick one that is too rich and you pay for coverage you never touch. This guide explains each tier, the fifth “Catastrophic” category, how tax credits and health savings accounts fit in, what is different for 2027 coverage and a simple way to choose. For the bigger picture on premiums, plan types and enrollment, see our health insurance guide for 2027.
Figures and rules come from HealthCare.gov, CMS, the IRS and KFF, checked October 2026. Prices for 2027 plans are posted on HealthCare.gov starting November 1, 2026, and state-run Marketplaces publish their own. This is general information, not insurance, tax or legal advice.
What the Metal Levels Actually Measure
Every Marketplace health plan has an actuarial value: the share of total covered medical expenses the plan is expected to pay for a standard group of people. The metal tier is simply a label for that percentage.
According to HealthCare.gov’s plan categories page, the splits look like this:
| Metal tier | Plan pays (average) | You pay (average) | Deductible is generally |
|---|---|---|---|
| Bronze | 60% | 40% | High |
| Silver | 70% | 30% | Moderate |
| Silver with cost-sharing reductions | 73% to 96% | 6% to 27% | Low |
| Gold | 80% | 20% | Low |
| Platinum | 90% | 10% | Low |
Averages, not promises
These percentages describe a large population, not one person. If you use almost no care in a year, a Bronze plan pays very little, because most of your spending falls under the deductible. If you have surgery, even a Bronze plan can pay well over 60% of the bill once you hit the out-of-pocket maximum. Your own split depends on the care you actually use.
How actuarial value is calculated
Insurers do not pick these percentages loosely. CMS publishes an actuarial value calculator that insurers use to test each plan design, running the plan’s deductible, copays, coinsurance and out-of-pocket maximum against a standard set of medical claims. Federal rules allow each plan a small range around its tier’s target, which is why two Silver plans can land at slightly different actuarial values. Actuarial value is an average across many people. It is useful for comparing plan designs, but your own out-of-pocket costs depend on the care you use.
Same benefits in every tier
HealthCare.gov notes that all Marketplace plans, in every category, must cover the same 10 essential health benefits, including preventive services. A Gold plan does not cover more conditions than a Bronze plan. What changes is how much you pay when you use those benefits.
What the essential health benefits include
HealthCare.gov lists the 10 essential health benefits that every Marketplace health insurance plan must cover, whatever its metal level:
- Outpatient care you get without being admitted to a hospital
- Emergency services
- Hospitalization, meaning inpatient hospital services such as surgery and overnight stays
- Pregnancy, maternity and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including dental and vision care for children
Plans can add medical services on top of this list, but they cannot drop any of these categories to reach a cheaper tier.
Not a quality rating
Metal levels have nothing to do with the quality of care. Plan quality is shown separately on HealthCare.gov as a star rating from 1 to 5. Network size and the plan type, such as HMO or PPO, are separate choices too; our comparison of HMO, PPO, EPO and POS plans explains how network rules differ.
Bronze Plans: Low Premiums, High Deductibles
Bronze plans have the lowest monthly premium of the four tiers and the highest out-of-pocket costs when you need care. Deductibles are generally high, so you pay the full negotiated price for many services until you reach it.
Who they tend to suit
- People who rarely see a doctor and mainly want protection against a large, unexpected bill.
- Households that want the lowest premium and can cover the deductible from savings if needed.
- People who want to contribute to a health savings account, since every Bronze plan is now HSA-compatible (more on that below).
What to check
Look closely at what the plan covers before the deductible. Preventive services are covered without cost-sharing in network on every Marketplace plan, and some Bronze plans also offer copays for primary care visits or generic drugs before the deductible. Two Bronze plans with the same premium can treat routine visits very differently.
The worst-case number
Bronze plans still have an out-of-pocket maximum. For 2027, federal rules cap in-network out-of-pocket costs at $12,000 for self-only coverage and $24,000 for a family, according to CMS guidance published January 29, 2026. Many plans set lower limits. If you could not cover your plan’s maximum in a bad year, a Bronze plan may be riskier than it looks.
Silver Plans and Cost-Sharing Reductions
Silver plans sit in the middle on both premiums and out-of-pocket costs. For many shoppers, their real importance is a feature no other tier has.
Extra savings only on Silver
Cost-sharing reductions, which HealthCare.gov calls “extra savings,” lower your deductible, copays, coinsurance and out-of-pocket maximum. They are available only to people whose income falls within a set range and only if they enroll in a Silver plan. People with income between 100% and 250% of the federal poverty level generally qualify, and the lower your income in that range, the larger the savings.
According to HealthCare.gov’s cost-sharing reductions page, you will know you qualify if your Eligibility Determination Notice says you can choose a plan with lower copayments, coinsurance and deductibles, followed by the code (04), (05) or (06).
Why this changes the math
With cost-sharing reductions, a Silver plan’s average share can rise from 70% to as high as 96%, which is richer than Platinum. Someone who qualifies and picks Bronze or Gold instead still gets any premium tax credit, but gives up those out-of-pocket savings entirely.
If your income changes
HealthCare.gov says that if you are in a Silver plan and lose your cost-sharing reductions, for example because your income rises above the range, you qualify for a Special Enrollment Period. You can then switch to a Bronze, Silver or Gold plan.
Silver premiums and “loading”
Federal cost-sharing reduction payments to insurers stopped in 2017, and many insurers responded by building the cost into Silver premiums. CMS’s 2027 payment rule refers to this as loading rates “to account for unreimbursed CSRs” and now requires insurers that do it to report details in their rate filings. Because the premium tax credit is pegged to a Silver plan, loading can make other tiers look relatively cheaper after the credit in some areas. The only way to know is to compare actual prices for your ZIP code.
Gold Plans: Higher Premiums, Lower Costs at the Doctor
Gold plans pay about 80% of covered costs on average. Premiums are higher than Bronze or Silver, and deductibles are generally low.
Who they tend to suit
- People who expect regular care: frequent specialist visits, ongoing prescriptions, a planned surgery or a pregnancy.
- Households that would rather pay a predictable premium each month than face large bills when care is needed.
- People who do not qualify for cost-sharing reductions but want lower cost-sharing than a standard Silver plan.
When Gold can beat Silver
If your income is above 250% of the poverty level, you cannot get cost-sharing reductions, so a Silver plan offers only its standard 70% value. In that case, compare the total yearly cost of Silver and Gold side by side. A Gold plan’s higher premium can be offset by lower deductibles and copays if you use a moderate amount of care.
Platinum Plans: The Richest Coverage
Platinum plans pay about 90% of covered costs on average, with the highest premiums and the lowest costs when you get care.
Who they tend to suit
This tier is built for people who expect heavy use of care, such as ongoing treatment for a serious condition, and who value predictable costs over a lower premium.
Availability
Platinum plans are not offered in every area. If your county has none, a Gold plan is usually the closest alternative, or a Silver plan with cost-sharing reductions if your income qualifies, since its value can exceed Platinum’s.
Out-of-Pocket Costs by Tier: A Worked Example
Percentages are easier to grasp with dollars attached. The example below uses two hypothetical plans with round numbers to show how the monthly premium and out-of-pocket costs trade off. Real plans in your area will have different figures, so use the method, not the numbers.
| Hypothetical plan | Monthly premium | Yearly premiums | Deductible | Out-of-pocket maximum |
|---|---|---|---|---|
| Bronze | $300 | $3,600 | $7,500 | $10,000 |
| Gold | $500 | $6,000 | $1,500 | $6,000 |
A light year
Suppose you use only preventive care plus a couple of sick visits. Preventive services are covered at no cost in network on both plans. If the sick visits cost a few hundred dollars and fall under the deductible, the Bronze plan’s total for the year is close to its $3,600 in premiums plus those visits. The Gold plan’s total is at least $6,000 in premiums plus any copays. Bronze wins by a wide margin.
A heavy year
Now suppose a hospital stay pushes you past both out-of-pocket maximums. Your spending is capped at the maximum, so the Bronze total is $3,600 plus $10,000, or $13,600. The Gold total is $6,000 plus $6,000, or $12,000. In this hypothetical, Gold comes out about $1,600 ahead, and it also spreads more of the cost into predictable monthly payments.
What the example shows
The cheaper plan is cheaper only when you stay healthy. For each plan you are considering, run the same two numbers, yearly premiums plus expected costs and yearly premiums plus the out-of-pocket maximum, and decide which risk you are more comfortable carrying. Your out-of-pocket costs also include anything out of network, which these limits generally do not cap.
Catastrophic Plans: The Fifth Category
Catastrophic plans are not one of the four metal tiers, but they are sold on the Marketplace in many areas. They have low premiums and very high deductibles and are meant to protect against worst-case events such as a serious illness or injury.
Who can buy one
According to HealthCare.gov’s Catastrophic plans page, these plans are open to people under 30 and to others who qualify for a hardship or affordability exemption.
That second group has grown. HHS issued guidance on September 4, 2025, extending a hardship exemption to people who cannot get premium tax credits or cost-sharing reductions because of their projected income. In its 2027 payment rule, CMS finalized a policy letting people who are ineligible for those savings because projected household income is below 100% or above 250% of the poverty level qualify for the exemption in every state, so they can enroll in Catastrophic coverage if otherwise eligible.
What they cover
Catastrophic plans cover the same 10 essential health benefits, including preventive care at no cost, and at least three primary care visits per year before the deductible.
The trade-off
You cannot use a premium tax credit on a Catastrophic plan, regardless of income, and cost-sharing reductions do not apply. People who qualify for savings often find a Bronze or Silver plan costs less after the credit. Compare before you choose.
Multi-year terms
The 2027 rule also set standards allowing Catastrophic plans with terms of up to 10 consecutive plan years. Ask the insurer how renewals and premiums work before you sign up for a multi-year plan.
Prescription Drugs and Metal Tiers
Prescription drugs are one of the 10 essential health benefits, so every Marketplace plan covers them. How much you pay depends less on the metal tier than on the plan’s drug list, called a formulary, and its drug tiers.
Metal tiers vs drug tiers
Do not confuse the two. Metal tiers describe the whole plan. Drug tiers sort the medications on a formulary, often from low-cost generics to preferred brands, non-preferred brands and specialty drugs, each with its own copay or coinsurance. Higher tiers often charge less per prescription, and some plans in every tier cover certain drugs, such as generics, before the deductible, but the details vary by insurer.
Check the formulary before you enroll
- Search each plan’s drug list for every medication you take, with the exact dose.
- Note the drug tier and whether the plan requires prior authorization or step therapy.
- Check whether drug costs count toward the deductible first, or have flat copays from day one.
- For expensive or specialty drugs, add the yearly drug cost to the worked example above. Ongoing prescription costs often push the math toward Silver or Gold.
If your drug is not covered
HealthCare.gov explains that if a drug you need is not on your plan’s list, you can ask the plan for an exception, usually with help from your doctor. If the plan says no, you can ask for an external review. Our guide on how to appeal a denied health insurance claim covers the steps.
Metal Tiers and Health Savings Accounts
A health savings account (HSA) lets you set aside pre-tax money for medical costs, and the balance carries over from year to year. You can contribute only while covered by an HSA-eligible plan.
Bronze and Catastrophic plans qualify
Under the 2025 federal budget law, bronze and catastrophic plans are treated as HSA-compatible starting January 1, 2026, even if their deductibles or out-of-pocket limits do not match the usual high-deductible plan rules. IRS Notice 2026-05 confirmed this and said the plans do not have to be bought through an Exchange to qualify. HealthCare.gov now states that all Bronze and Catastrophic plans work with HSAs, and some plans in other tiers do too. When you preview plans, the “Eligible for an HSA” filter shows them.
2027 contribution limits
| HSA limit | 2027 |
|---|---|
| Self-only coverage | $4,500 |
| Family coverage | $9,000 |
| Extra catch-up contribution, age 55 or older | $1,000 |
The 2027 limits come from IRS Revenue Procedure 2026-24. Enrolling in Medicare ends your ability to contribute.
Why this matters for tier choice
Pairing a Bronze plan with an HSA lets you pay the deductible with tax-free dollars. That softens one of Bronze’s biggest drawbacks, but only if you actually fund the account.
How Premium Tax Credits Fit In
The premium tax credit lowers your monthly premium in any of the four metal tiers. It is calculated using the second-lowest-cost Silver plan in your area, called the benchmark plan, and the share of income you are expected to contribute.
Advance premium tax credit or a refund at tax time
You can take the credit in advance, called the advance premium tax credit (APTC), which the government pays straight to your insurer each month to lower your bill. You can also pay the full premium and claim the whole credit when you file. Either way, you reconcile the credit on IRS Form 8962 with your tax return, so a raise or a new job during the year can change what you owe or get back. Reporting income changes to the Healthcare Marketplace as they happen keeps the advance amount closer to the final number.
The 2027 rules
The enhanced credits that began in 2021 expired at the end of 2025 and have not been renewed, according to KFF. For 2027, IRS Revenue Procedure 2026-26 sets expected contributions from 2.15% of income for households below 133% of the poverty level up to 10.22% for those between 300% and 400%. Households above 400% of the poverty level generally receive no credit.
How the credit moves between tiers
Because the credit is a fixed dollar amount based on the benchmark Silver plan, applying it to a cheaper Bronze plan can shrink your premium sharply, sometimes to very little. Applying it to a Gold or Platinum plan leaves you paying the difference above the benchmark. Our explainer on deductibles, copays, coinsurance and out-of-pocket maximums helps you weigh that lower premium against higher costs at the doctor.
What people did in 2026
KFF reported in October 2026 that after the enhanced credits expired, many enrollees switched to lower-premium plans with higher deductibles, and average deductibles rose 37%, or about $1,000 per person. A lower premium can still be the right call, but it moves risk onto you when you need care.
Job-based coverage, minimum value and ACA compliance
Metal tiers apply to Marketplace and small-group plans, but job-based coverage uses a related test called minimum value. Under IRS and HHS rules, an employer plan provides minimum value only if it covers at least 60% of the total allowed costs of benefits and gives substantial coverage of inpatient hospital services and physician services. That 60% line is the same actuarial value as a Bronze plan. If your employer offers you coverage that meets minimum value and counts as affordable under IRS rules, you generally cannot get a premium tax credit for a Marketplace plan instead.
For employers, this is part of ACA compliance. The IRS employer shared responsibility rules apply to applicable large employers, generally those with 50 or more full-time employees including full-time equivalents, which can owe a payment if they do not offer affordable, minimum value coverage to full-time staff and at least one of them gets a premium tax credit. Small employers are not subject to that payment, so their workers often compare a job-based plan with the Marketplace directly.
Metal tiers are one small part of a large health care system, but they are the part you control each fall, which is why the side-by-side math below is worth an hour of your time.
What Is Different for 2027 Plans
A few changes affect how tiers look on HealthCare.gov this fall.
- Prices are rising. KFF’s analysis of insurer filings found a median proposed premium increase of 15% for 2027.
- Standardized plans are no longer required. CMS’s 2027 rule ended the requirement that insurers on HealthCare.gov offer standardized plan options and the special display for them, so plan designs within one metal tier may vary more than before. Read each plan’s summary of benefits rather than assuming two Gold plans work the same way.
- The out-of-pocket ceiling went up. The federal maximum rises to $12,000 for self-only coverage and $24,000 for a family in 2027.
- Catastrophic eligibility widened. The hardship exemption described above now applies in all states.
How to Choose a Metal Tier
Comparing tiers properly takes about an hour. Have your income estimate, your doctors’ names and your prescription list ready.
Step 1: Check your savings first
Fill out the Marketplace application with your best estimate of 2027 household income. If you qualify for cost-sharing reductions, start your comparison with Silver plans, since no other tier gives you those savings.
Step 2: Estimate how much care you will use
Count the doctor visits, specialist appointments, prescriptions and planned procedures you expect next year. Light users usually lean toward Bronze; heavier users usually come out ahead with Gold or Platinum.
Step 3: Calculate a worst-case year
For each plan, add 12 months of premiums to the out-of-pocket maximum. That total is the most you would pay for covered in-network care in a bad year.
Step 4: Calculate a typical year
Add 12 months of premiums to the copays and coinsurance you expect for your usual care. The plan with the lowest premium is often not the plan with the lowest total cost.
Step 5: Confirm doctors and drugs
Metal tier does not decide your network. Search each plan’s provider directory and drug list, then call your key doctors to confirm they take that exact plan for 2027.
Step 6: Enroll on time
On HealthCare.gov, open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027. Enroll by December 15 for coverage that starts January 1. Outside that window you need a qualifying life event; our article on open enrollment and Special Enrollment Periods lists them.
A quick reference
| Situation | Tier to look at first |
|---|---|
| Income between 100% and 250% of the poverty level | Silver, for cost-sharing reductions |
| Healthy, rarely uses care, wants an HSA | Bronze |
| Under 30 or qualifies for a hardship exemption and gets no tax credit | Catastrophic, compared against Bronze |
| Regular specialist visits or ongoing prescriptions | Gold |
| Very high expected use and Platinum is offered | Platinum, compared against Gold |
Frequently Asked Questions
What do the ACA metal tiers mean?
They describe how costs are shared. On average, Bronze plans pay about 60% of covered costs, Silver 70%, Gold 80% and Platinum 90%. You pay the rest through deductibles, copays and coinsurance. All tiers cover the same essential health benefits.
Is a Gold plan better than a Silver plan?
Not automatically. Gold has higher premiums and lower costs when you get care. If you qualify for cost-sharing reductions, a Silver plan can be worth more than Gold. Compare total yearly cost for the care you expect.
Can I use my premium tax credit on any metal tier?
Yes, on Bronze, Silver, Gold or Platinum plans. The credit cannot be used on a Catastrophic plan.
Which Marketplace plans work with an HSA in 2027?
All Bronze and Catastrophic plans, plus some plans in other tiers that meet IRS high-deductible rules. Use the “Eligible for an HSA” filter on HealthCare.gov.
Who can buy a Catastrophic plan?
People under 30 and people who qualify for a hardship or affordability exemption. That includes people who are ineligible for premium tax credits or cost-sharing reductions because of projected income below 100% or above 250% of the poverty level.
Does the metal tier affect which doctors I can see?
No. Networks depend on the insurer and plan type, such as HMO or PPO, not the metal level. Check each plan’s provider directory.
What is the actuarial value of a health plan?
It is the share of total covered medical expenses a plan is expected to pay for a standard population: about 60% for Bronze, 70% for Silver, 80% for Gold and 90% for Platinum. Insurers test plan designs with a CMS calculator.
Which metal tier is best for prescription drugs?
It depends on the drugs. Check each plan’s formulary and drug tiers. People with regular brand-name or specialty prescriptions often pay less overall with Silver (especially with cost-sharing reductions) or Gold, but compare the yearly totals.
Does a lower monthly premium always save money?
No. A lower monthly premium usually means higher deductibles and out-of-pocket costs. Add a year of premiums to your expected costs and to the out-of-pocket maximum to compare.
Does an employer plan have a metal tier?
Many small-group plans are sold in the same Bronze to Platinum levels. Larger employer plans usually are not labeled that way, but they must meet a minimum value standard of at least 60% actuarial value with substantial coverage of inpatient hospital services and physician services.
Sources
- HealthCare.gov, Health plan categories: Bronze, Silver, Gold and Platinum; Catastrophic health plans; Cost-sharing reductions.
- CMS, HHS Notice of Benefit and Payment Parameters for 2027 final rule fact sheet (May 15, 2026).
- CMS, Premium Adjustment Percentage and Maximum Annual Limitation on Cost Sharing for the 2027 Benefit Year (January 29, 2026).
- IRS Notice 2026-05 (HSA changes under the 2025 budget law), Revenue Procedure 2026-24 (2027 HSA limits) and Revenue Procedure 2026-26 (2027 applicable percentage table).
- KFF, “How Much and Why ACA Marketplace Premiums Are Going Up in 2027” and “Midterm Election Update: The Affordable Care Act Marketplaces” (October 6, 2026).
- HealthCare.gov, Getting prescription medications (formulary exceptions). Worked-example plan figures are hypothetical.
- 26 CFR 1.36B-6 and 45 CFR 156.145 (minimum value: 60% and substantial coverage of inpatient hospital and physician services); IRS, Questions and Answers on Employer Shared Responsibility Provisions; HealthCare.gov, What Marketplace health insurance plans cover (10 essential health benefits).
