Some people get confused because they think metal tiers describe the quality of the plan or the quality of the service they’ll receive, which isn’t true.
Here’s how health insurance plans roughly split the costs, organized by metal tier:
Bronze – 40% consumer / 60% insurer
Silver – 30% consumer / 70% insurer
Gold – 20% consumer / 80% insurer
Platinum – 10% consumer / 90% insurer
These are high-level numbers across the entirety of the plan, taking into account the deductible, coinsurance, and copayments, as dictated by the specific structure of the plan, based on the expected average use of the plan. These percentages do not take premiums into account. They also do not represent the exact amount that you’ll actually pay for medical services.
In general, Bronze plans have the lowest monthly premiums and Platinum plans have the highest, with Silver and Gold occupying the price points in between. As you can see from the cost-sharing split above, Bronze plan premiums are cheaper because the consumer pays more out of pocket for health care services. If you frequently utilize health care services, you’ll probably end up paying more out-of-pocket if you choose a Bronze plan, even though it has a lower premium.
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