Metal tiers describe the split between what the plan pays and what you pay across a typical population. Bronze carries the least of your costs at the lowest premium; platinum the reverse. The tier says nothing about the quality of the doctors or the size of the network.
- Bronze — lowest premium, highest deductible. Suits someone who rarely uses care and wants protection from catastrophe.
- Silver — the tier where cost-sharing reductions attach for lower incomes, which frequently makes it cheaper in total than bronze despite the higher premium.
- Gold and platinum — higher premium, lower cost at the point of care. Suits predictable, regular medical needs.
The mistake worth avoiding. People moving off a $0-premium program sort by price, pick bronze, and then meet a deductible they cannot clear when they need care. At modest incomes, price out silver with cost-sharing reductions before deciding.
Whatever tier you pick, the network question is separate and matters more day to day.
In New York: all four levels are sold through NY State of Health, and one of them carries hidden help. Silver plans are the only ones that carry cost-sharing reductions, available to households between 100% and 250% of the federal poverty level, which can make a silver plan cheaper over a year than a bronze plan with a lower premium. Below 200% of the poverty level, adults aged 19 to 64 are usually placed in the Essential Plan instead and buy nothing at all.
Also called: bronze plan, silver plan, gold plan, metal level. Reference: Metal tiers (bronze, silver, gold, platinum) on Wikipedia — general definition, not New York specifics.
More in Glossary of health coverage and billing terms
- Out-of-pocket maximum — The out-of-pocket maximum caps your cost sharing for covered in-network care each plan year. What counts toward it, what never does, and the New York rules.
- Network (in-network and out-of-network) — The set of doctors and hospitals your plan has contracted with. Outside it, you pay much more.
- Formulary — A formulary is a plan's list of covered drugs, sorted into tiers that set your cost. What on-formulary means, how exceptions work, and New York's NYRx list.
This page explains how the system works. It is not medical advice. More.