Affordable Care Act

What Is a Silver Health Plan?

Published on January 30, 2019


ACA Marketplace healthcare plans come in four metal levels — Platinum, Gold, Silver and Bronze, plus, in some markets, catastrophic health plans available to those under 30. The health plan you choose during open enrollment is the one you will use all year. This is why it is so important to choose the metal level that works best for you. For some people, this will be the Silver health plan. Understanding the benefits and drawbacks of each health plan level can help you choose well and get the most of your health insurance all year.

What is a Silver health plan?

A Silver health plan is the metal level that falls around the middle of the pack. The premiums are about halfway between the cheapest and most expensive options. The out of pocket expenses for medical care with a Silver health plan are, as well. In general, your insurer wil pick up about 70% of the cost with a Silver health plan, leaving you responsible for the remaining 30%. However, Silver health plans offer some benefits that can actually make your health costs lower through what is known as Cost-Sharing Reductions.

What are Cost Sharing Reductions?

Cost sharing reductions are extra savings that are available to people within a certain income range who choose a Silver health plan. These reductions work with a Silver health plan in a few different ways:

  • a lower deductible. With most health plans, you will have a specific deductible that you must meet each year before your insurance kicks in. For instance, you may have a deductible of $1200 per year. However, if you qualify for a cost sharing reduction, your deductible may be reduced to $700, $500 or another number based on your income.
  • lower copays or coinsurance. This means that you may see these per visit fees drop, for instance, from $35 to $15 or $20. This means you pay less each time you visit the doctor on your Silver health plan.
  • lower out of pocket maximums. ACA health insurance plans typically have a maximum out of pocket limit. After that is met, the insurance company absorbs all covered costs. With a Silver health plan and cost sharing reduction, your out of pocket can drop significantly.

How much does a Silver health plan cover?

In general, a Silver health plan covers around 70% of medical services. You can see how the plans stack up below:

Plan Category  Insurance pays   Insured pays 
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%

Who should get a Silver health plan?

A Silver health plan is a good choice for many people, because it balances premium and out of pocket medical costs. However, if you are young, do not anticipate using insurance often and have significant amounts of cash in savings, you may find that you save money with a Bronze or catastrophic plan. Similarly, if you are older or have a chronic health condition that results in using large amounts of healthcare services, a Silver health plan may cost you more than a Gold or Platinum plan.
Having a licensed health insurance broker like eHealth to provide guidance can help you make the right decision for you and your health. Get in touch today to learn more about health insurance options that include the Silver health plan and more.

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