What Are The Four Metal Tiers of ACA Plans?

The Marketplace is an online exchange used to compare and purchase ACA-compliant insurance. In the Marketplace, plans are categorized into metal tiers. Each metal tier offers a different level of coverage at varying price points. When choosing coverage, it helps to understand how the various metal tiers work. 

Continue reading to learn what the four metal tiers of ACA plans are. 

What Are Metal Tiers?

Regardless of where you are located, all Marketplace plans are separated into four metallic levels. These levels, or tiers, are Bronze, Silver, Gold, and Platinum. The metal tier is decided based on how much you and the plan can expect to share health care costs. 

How Do Metal Tiers Differ?

Plans at the beginning of the spectrum will require higher copayments, deductibles, and coinsurance, while the end of the spectrum provides more coverage with higher premiums. The out-of-pocket maximum also varies from plan to plan and across the metal tiers. For example, a Platinum plan may have lower maximums, meaning the amount you pay out-of-pocket can be capped before you spend as much as you would with a Bronze tier plan. 

What Benefits Are Offered?

All ACA plans will cover the ten essential health benefits, regardless of the metal tier. These essential health benefits include:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency services
• Hospitalization (like surgery and overnight stays)
• Pregnancy, maternity, and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

You may still be required to pay a copayment or coinsurance for covered health benefits. If a service is not covered by your plan, you will be required to pay all associated costs. 

Be aware that the benefits offered by ACA plans aren’t limited to the essential health benefits. The essential health benefits are simply the minimum level of coverage available. Meaning, you can find plans that offer additional coverage. 

Find The Right Metal Tier

Choosing a plan that falls into the right metal tier will help you save on coverage in the long term. We can help you decide which metal tier is right for you, allowing you to save time in the shopping process. 

To get a free quote on ACA coverage, contact a specialist today. You can reach an agent now by calling 888-989-0079.