What do the Different Levels of Obamacare Health Plan Entail?

Obamacare health plan is among the most preferred insurance plans for many Americans. Like many other plans it is offered at different levels namely Platinum, Gold, Silver and Bronze. Just like in nature, these come at different prices but with health plans it is not just about the cost but so much more. Also known as metal plans, these plans correspond to the metals they are named after in terms of value. Here is a detailed look at each of these tiers starting from the least to the most valuable.


This is the cheapest plan that has an actuarial value of 60%. This means that on average, it will cater for 60% of the covered hospital expenses for the insured person(s). The remaining 40% will be paid for by the policy holder. This plan is ideal for low-income earners who do not plan on having many medical services since they would otherwise spend much paying out-of-pocket costs. The benefits provided by the plan are basic and the hospital and doctors networks covered narrow.


Thanks to advanced premium tax credits those who earn less than 400% of the Federal Poverty Level Chart, this plan costs 9.5% of your income or less. Though the actuarial value may differ depending on factors like your state and profession, a Silver plan must have a value of at least 70%. For low income earners this may be a more viable option especially if you qualify for cost reduction subsidy. This is a subsidy in which reduces the out-of-pocket payments you make in the course of a policy period such as a year. In order to qualify for this, you need to be among those who earn up to four times the Federal Poverty Level (that is 250% below the Federal Poverty Limit or about $46,500). This can increase the actuarial value by up to 93%.


Though this will cost you more than bronze and silver on a monthly basis, the Gold plan has better out-of-pocket cost sharing coverage with an actuarial value of 80%. This means that you and your family members will get the healthcare they need without having to worry about money when the time comes.


This plan has the highest monthly premiums but the lowest out-of-pocket costs. The actuarial value is on average at 90%. If you want the best care for your family or have a medical condition that requires expensive care continuously then this is the plan to settle for. This is only advisable for those whose medical expenditure may be more than that of the premiums paid.

In general, all plans offer essential health benefits including prevention and wellness, laboratory services, ambulatory services, emergency care, pediatric care, mental health and substance use disorder, maternity and rehabilitation. The only major differences come in the actuarial values and the monthly premiums paid. Another plan level offered by the Obamacare is catastrophic plan which caters for people under the age of 30 who have limited income. These are characterized by low monthly premiums, narrow network and high out-of-pocket expenses but is useful in ensuring young adults comply with the need to have an insurance and prevent them from paying the shared responsibility fee for not having the coverage.