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Metal Levels

The health insurance marketplace provides four tiers of health coverage known as “metal” levels: bronze, silver, gold, and platinum.


Generally, bronze plans have the lowest monthly premiums (your monthly insurance bill), but they have also have high deductibles and out-of-pocket costs. In most cases, bronze plans do not include co-pays for doctor visits or any other form of co-payment.


In contrast, platinum plans have the highest monthly premiums but provide low deductibles, co-payments, and significantly mitigate out-of-pocket costs.


The cost sharing between metal plans and the insurance company


Insurance Company’s Cost Share                 Your Cost Share


Bronze                                                60%                                                     40%

Silver                                                  70%                                                     30%

Gold                                                    80%                                                     20%

Platinum                                             90%                                                     10%


In order to reduce your monthly premium you may apply for a tax credit (government subsidy). In order to qualify for a subsidy, your household income must be within the parameter of 100-400% of the Federal Poverty Level (FPL). Individuals earning less than 100% of the FPL are ineligible for subsidized health coverage through the marketplace, and must enroll in Medicaid. Applicants with a household income above 400% of the FPL do not qualify for subsidized healthcare.



Many people are aware of the subsidies being offered by the government, but very few know that the government offers an additional benefit known as Cost-Share-Reduction (CSR). In order to qualify for CSR benefits, your household income must fall between 100-250% of the FPL. Consequently, people that go online and sign up by themselves are failing to take     advantage of the benefits our new healthcare system provides. The Health Insurance Marketplace is a difficult website for any layman to navigate. Even if you’ve managed to enroll in a healthcare plan via it is highly likely that you did not elect the coverage that would best suit your needs. Unless you’re a licensed health insurance agent; your failure to identify the multiple nuances throughout the application consequently prohibit enrolling in optimal coverage that is personalized to fit your needs.



Do not settle for lackluster coverage by enrolling yourself through Find your local agency and have an agent take you through the process… A good agent will be familiar with the many facets of the enrollment process and present you with the best coverage available… REMEMBER – allowing an insurance agent to write your insurance policy is absolutely free… Take this unbiased advice and utilize the expertise of your local agents.


For further information contact Simerly-Ayers Insurance Group at 850.244.3472.