There are four "metal tiers" associated with health plans. In addition, there are plans called "high deductible health plans" and "catastrophic plans."
Bronze, Silver, Gold, and Platinum make up the metal tiers. Bronze tier has the lowest premium but the highest prices for care. On the other end, Platinum tier has the highest premium, but the lowest care prices.
Below is an overview of the amount of coverage you can generally expect your health insurance plan to pay for based on the metal tier. Keep in mind, you must meet your deductible before insurance pays for many services.
Has the highest premium but the lowest cost per need. Estimation: Provider pays for 90% of care.
Has a high premium but a low cost per need. Estimation: Provider pays for 80% of care.
Has a middle range premium and a middle range cost per need. However, it allows you to qualify for cost-sharing reductions. Estimation: Provider pays for 70% of care.
Has a low premium but a high cost per need. Estimation: Provider pays for 60% of care.
High Deductible Health Plans (HDHPs)
This refers to any plan that has a deductible of at least $1,400 for an individual or $2,800 for a family. A HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $7,050 for an individual or $14,100 for a family except for services that are out-of-network.
Has a low premium but very high cost for care. Annual deductible for out-of-pocket expenses: $9,100 for an individual in 2023.
Catastrophic plans are another type of coverage. These plans generally have the the lowest premiums and the highest cost. The name comes from the basic idea that, outside of catastrophe, you bear much of the cost of care.
While they cover the 10 Essential Health Benefits outlined by the Affordable Care Act, these plans exist outside the metal tier framework and have eligibility requirements. You must be under 30 years old or else prove you are experiencing financial or other challenges that qualify you for this plan type (officially referred to as a "hardship or affordability exemption").
Catastrophic plans are also not eligible for government subsidies like premium tax credits.