Health insurance Marketplace plans: metal levels and open enrollment
Marketplace plans come in Bronze, Silver, Gold and Platinum levels. The level tells you how costs are split, not the quality of care.
Sourced from official pages · Updated September 30, 2026💡 Key takeaways
- Marketplace plans come in four metal levels: Bronze (plan pays about 60% on average), Silver (70%), Gold (80%) and Platinum (90%).
- Lower monthly premiums generally mean higher costs when you get care.
- Open Enrollment runs November 1 to January 15; enroll by December 15 for coverage starting January 1.
- Compare total expected cost, your doctors and drugs, and the plan type.
The four metal levels
| Level | Plan pays on average | You pay on average |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
These percentages are averages across all covered people and services; your own costs depend on how much care you use. Lower-premium plans generally have higher out-of-pocket costs when you get care.
🔤 Key terms
- Premium: what you pay each month to have the plan.
- Deductible: what you pay for covered care before the plan starts paying (some services are covered before the deductible).
- Copayment / coinsurance: a fixed amount or a percentage you pay for covered services.
- Out-of-pocket maximum: the most you pay in a year for covered in-network care.
Enrollment dates
Open Enrollment is the yearly period from November 1 to January 15. Enroll by December 15 for coverage that starts January 1. You may qualify to enroll outside Open Enrollment after certain life events, such as losing other coverage.
How to compare plans
Look at total expected cost (premiums plus what you expect to pay for care), your doctors and drugs (network and formulary), and plan type (HMO, PPO and others). Use HealthCare.gov to compare plans for your area.
Estimating total yearly cost
- Multiply the monthly premium by 12.
- Add the deductible if you expect to use significant care, plus copays and coinsurance.
- Compare with the out-of-pocket maximum, the most you would pay for covered in-network care.
Plan types
| Type | How it works |
|---|---|
| HMO | Usually requires you to use in-network providers and get referrals for specialists |
| PPO | More flexibility to see out-of-network providers, usually at higher cost |
| EPO | Network only, generally no referrals |
| POS | Mix of HMO and PPO features |
Check the plan’s details on HealthCare.gov for how each works in your area.
Special enrollment
You may be able to enroll outside Open Enrollment after certain life events, such as losing other coverage. Check the dates and deadlines on HealthCare.gov.
🔤 Key terms
| Term | Meaning |
|---|---|
| Premium | Monthly cost of the plan |
| Deductible | Amount you pay before the plan pays for many services |
| Copayment | Fixed amount for a service |
| Coinsurance | Percentage of cost you share after the deductible |
| Out-of-pocket maximum | The most you pay in a year for covered in-network care |
| Network | Doctors and hospitals that contract with the plan |
Step by step: choosing a plan
- List your doctors, medications and expected care.
- Compare plans in your area on HealthCare.gov.
- Check each plan’s network and drug list.
- Estimate total yearly cost.
- Enroll before the deadline.
🧮 Illustration: what “60/40” and “80/20” mean (hypothetical)
If a group of people with a Bronze plan incurs $10,000 in covered care on average, the plan pays about $6,000 and they pay about $4,000. On a Gold plan, the plan pays about $8,000 and they pay about $2,000. Real costs depend on the deductible, copays and how much care you use, so use this only to understand the averages.
⚠️ Common mistakes to avoid
- Picking a plan only for the lowest premium.
- Not checking whether your doctors and drugs are covered.
- Missing the enrollment deadline.
- Forgetting the out-of-pocket maximum when budgeting.
- Ignoring special enrollment options after a life event.
🛠️ Try it yourself
❓ Frequently asked questions
When is Open Enrollment?
November 1 to January 15; enroll by December 15 for coverage that starts January 1.
What is the difference between a deductible and out-of-pocket maximum?
The deductible is what you pay before the plan starts paying on many services; the out-of-pocket maximum is the most you pay in a year for covered in-network care.
Do metal levels affect the quality of care?
No; they describe how you and the plan share costs.
Can I keep my doctor?
Check that your doctor is in the plan’s network.
📚 Sources
This guide is general information, not financial, tax or legal advice. Rules and limits change; confirm with the sources above or a licensed professional.