The Four Plan Levels Available Through Health Insurance Exchanges

Four predetermined plan levels are defining factors of the health insurance exchange program which is a marketplace where individuals and businesses can shop for coverage. The four plan levels stipulate the amount of coverage you will receive if you seek health insurance through an exchange.

The four plan levels are:

  • Platinum — Covers 90 percent of average medical costs with consumer cost-sharing of 10 percent.
  • Gold — Covers 80 percent of average medical costs with consumer cost-sharing of 20 percent.
  • Silver – Covers 70 percent of average medical costs with consumer cost-sharing of 30 percent.
  • Bronze Covers 60 percent of average medical costs with consumer cost-sharing of 40 percent.

Additionally, catastrophic coverage only plans will be available to individuals under the age of 30. Consumer cost-sharing includes things such as deductibles, copayments and coinsurance. Plans offering the most coverage, such as Platinum and Gold, will have higher premiums and a lower level of consumer cost-sharing. Bronze and Silver plans will be cheaper to buy, but will expose you to substantial cost-sharing over time.

If you’re enrolling in exchange coverage through your employer, your choice of plan levels will be limited to only those your employer decides to make available. However, individual purchasers can select from any tier level.

One thing to keep in mind when considering the different plan levels — all of the tiers must provide a basic level of essential benefits that offer coverage for things such as preventive care, hospitalization and prescription drugs.

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