The four tiers at a glance
Metal tiers are a standardized way to describe how a plan splits costs between you and the insurance company. The key number is the actuarial value (AV), which is the percentage of total medical costs the plan covers on average, across all members.
Plan pays
70%
You pay
30%
Typical deductible
$4,000 - $6,000
Out-of-pocket max
$9,200
Monthly premium
Moderate
HSA eligible?
Sometimes
Best for
A solid middle ground. If your income is below 250% FPL, pick Silver to unlock cost-sharing reductions (see the CSR tabs).
| Bronze | Silver | Gold | Platinum | |
|---|---|---|---|---|
| Plan pays | 60% | 70% | 80% | 90% |
| Deductible | $7,000 - $9,000 | $4,000 - $6,000 | $1,000 - $2,500 | $0 - $500 |
| OOP max | $9,200 | $9,200 | $9,200 | $4,000 - $5,000 |
| Premium | Lowest | Moderate | Higher | Highest |
| HSA? | Often | Sometimes | Rarely | No |
Deductible and OOP max ranges are typical for individual coverage in 2026. The federal OOP maximum is $9,200. CSR Silver plans are available only through the marketplace and only on Silver-tier plans. CSR deductible and OOP max figures reflect the enhanced plan you actually receive, not the underlying Silver plan.
A Bronze plan with 60% AV doesn't mean you pay 40% of every bill. It means that across the entire pool of people on that plan, the insurer pays about 60% of total costs. Your individual experience depends on your deductible, copays, coinsurance, and how much care you use.
Bronze: lowest premium, highest risk
Bronze plans typically have deductibles in the $7,000 to $9,000 range for an individual. That means you pay full price for most services until you hit that number. After the deductible, you usually pay 30-40% coinsurance until you reach the out-of-pocket maximum.
The 2026 federal out-of-pocket maximum is $9,200 for an individual. Many Bronze plans set their OOP max right at that limit.
Bronze makes sense if you rarely see a doctor, don't take regular prescriptions, and mainly want protection against a catastrophic event like a hospitalization or surgery. The monthly premium savings can be substantial, often $100-$200 less per month than a Silver plan.
The risk: if you do need care, you'll pay a lot before insurance kicks in. A single ER visit or imaging scan can easily run $2,000-$5,000 before you've hit your deductible.
Many Bronze plans are HSA-eligible, which gives you a tax-advantaged way to save for those costs.
Silver: the sweet spot for most people
Silver plans sit in the middle, with deductibles typically around $4,000-$6,000. But the real advantage of Silver is cost-sharing reductions.
If your income is below 250% of the federal poverty level ($39,125 for a single person in 2026), and you pick a Silver plan, the insurer is required to give you a beefed-up version with better benefits:
- Below 150% FPL: Your Silver plan has a 94% actuarial value. That's better than Platinum. Deductibles are often close to $0, and copays are minimal. This is the best deal on the marketplace.
- 150% to 200% FPL: Your plan has an 87% AV. Deductibles around $800-$1,500. Still very good.
- 200% to 250% FPL: Your plan has a 73% AV. A modest improvement over standard Silver.
CSR Silver plans are available only on Silver. If you qualify for CSR and pick a Bronze or Gold plan instead, you lose these benefits. This is why financial advisors and enrollment counselors almost always recommend Silver for lower-income households.
Gold: higher premium, lower bills
Gold plans typically have deductibles in the $1,000-$2,500 range. Copays are usually fixed dollar amounts ($30 for a primary care visit, $50 for a specialist) rather than a percentage, which makes costs more predictable.
Gold works well for people who use care regularly: ongoing prescriptions, frequent specialist visits, physical therapy, mental health appointments. You pay more each month, but you pay much less each time you walk into a doctor's office.
The break-even point depends on your specific plans and usage. But as a rough guide, if you expect to spend more than a few thousand dollars on care during the year, Gold often comes out ahead of Bronze and sometimes ahead of Silver too.
Platinum: rare and expensive
Platinum plans cover about 90% of costs. Deductibles are very low or $0, and copays are minimal. But they're expensive, and they're not available everywhere. Many counties only have Bronze, Silver, and Gold options.
Platinum makes sense if you have very high, predictable medical costs and you want the most comprehensive coverage available. But for most people, a CSR Silver plan (if you qualify) or a Gold plan offers similar benefits at a lower premium.
What about Catastrophic plans?
Catastrophic plans are available to people under 30 or those with a hardship exemption. They have very low premiums and very high deductibles (at the federal maximum). They cover three primary care visits per year before the deductible and preventive services at no cost, but everything else is on you until you hit the deductible.
You cannot use a premium tax credit on a Catastrophic plan.
How to decide
There's no universal right answer. But some rules of thumb:
- Income below 250% FPL? Pick Silver to get CSR benefits. It is almost always the best value.
- Healthy and rarely use care? Bronze keeps your monthly cost low. Consider pairing it with an HSA.
- Regular prescriptions or ongoing treatment? Compare Gold to Silver. Add up expected costs for both, not just premiums.
- Not sure? Silver is the default recommendation for a reason. It balances premiums and coverage well, and it's the only tier that gets CSR benefits.