The different plan levels offered by Georgia Access, where the categories (often called "metal tiers") are based on how you and your insurance plan split the cost of using healthcare services, not quality of care.
For each plan category, you’ll pay a different percentage of total costs for your care, and your insurance company will pay the rest. The lower the metal tier, the lower your monthly premium, but the more out-of-pocket costs you'll need to pay when you use healthcare services.
It is important to look at the total cost of health coverage - not just premiums - when choosing the right health coverage for you and your family. Total costs also include deductibles, and other out-of-pocket costs like co-payments and co-insurance.
Example:
|
Plan Category |
The insurance company pays |
You pay (co-insurance) |
|
Platinum |
90% |
10% |
|
Gold |
80% |
20% |
|
Silver |
70% |
30% |
|
Bronze |
60% |
40% |
Which metal category is right for you?
Platinum
Highest monthly premium
Lowest costs when you use healthcare services.
Deductibles are very low, meaning your plan starts paying its share for covered services earlier than other plan categories.
Good choice if: You usually use a lot of care and are willing to pay a higher monthly premium, knowing nearly all other costs will be covered.
Gold
Higher monthly premium
Lower costs when you use healthcare services
Gold plan deductibles are usually low.
Good choice if: You’re willing to pay more each month to have more costs covered when you use healthcare services. If you use a lot of care, a Gold plan could be a good value.
Silver
Moderate monthly premium
Moderate costs when you use healthcare services.
Silver deductibles — the costs you pay yourself before your plan pays anything — are usually lower than those of Bronze plans.
IMPORTANT: If you qualify for cost-sharing reductions you must pick a Silver plan to access these savings. You can save hundreds or even thousands of dollars per year depending on how much care you use.
Good choice if: You qualify for cost-sharing reductions— or, if not, you’re willing to pay a slightly higher monthly premium than Bronze to have more of your routine care covered.
Bronze
Lowest monthly premium
Highest costs when you use healthcare services.
Bronze plan deductibles — the amount of healthcare costs you pay yourself before your insurance plan starts to pay — can be thousands of dollars a year.
Good choice if: You want a low-cost way to protect yourself from worst-case medical scenarios, like a serious illness or injury. Your monthly premium will be low, but you’ll have to pay for most routine care yourself.
Catastrophic
Catastrophic health insurance plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.
Only the following people are eligible for catastrophic plans:
People under 30
People of any age with a hardship exemption or affordability exemption (based on Georgia Access or job-based insurance being unaffordable)