Choosing an Obamacare or Off-Exchange plan
The key ideas that make comparing plans simple
The two types of health insurance costs
Monthly premium
The fixed monthly cost of the plan — what you pay whether or not you use any care.
Out-of-pocket costs
What you pay when you need medical care — deductible, copays, and coinsurance.
Together, these two make up the total cost of your healthcare needs.
What the "metal levels" mean
Metal levels describe how your total healthcare costs are split between the monthly premium and out-of-pocket costs.
| Plan | Premium share | Out-of-pocket share |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
For example, Bronze plans have low monthly premiums but high out-of-pocket costs, while Platinum plans have high premiums but low out-of-pocket costs.
How to think about your "risk" decision
Once you understand the two types of costs and the metal levels, the choice comes down to a trade-off:
Lower premium now
Pay less each month, and accept the risk of paying a larger share of your medical costs if you need care. A fit for very healthy people comfortable taking that risk — often a Bronze plan.
Higher premium now
Pay more each month, and face less risk because you'll pay a smaller share when you need care. A fit for those who'd rather not take a risk — often a Platinum plan.
Everyone answers this differently. For many, a Silver or Gold plan with mid-level premiums and out-of-pocket costs is the right balance.
The HPR affordability rank
We created our own ranking system to help you weigh the affordability of each plan. It's based on the combination of the annual premium and the total average out-of-pocket costs we estimate the average person will face for that plan. Remember it's an average — some people need a lot of care, others very little.
What is an Obamacare subsidy?
The Obamacare subsidy is a tax credit you can use to reduce the monthly premium of a plan. Your eligibility and amount depend on your annual household income. We estimate whether you're eligible and how much, but you'll need to complete the federal government application to learn your official amount — we can connect you to certified web brokers who help you apply.
What are Cost Sharing Reduction (CSR) plans?
If you're eligible for a subsidy, you may also be eligible for Cost Sharing Reduction plans. CSR plans are Silver plans with lower out-of-pocket costs (deductibles, copays, coinsurance) than normal Silver plans — a second form of financial assistance. Pay close attention to these, as they're likely your most affordable option.
What else should I consider?
Does my doctor or hospital accept this plan?
To be sure, check the health insurance company's official provider directory. We show a link to the official provider directory for each plan — look for the Doctor Lookup link on Health Plan Radar.
Are my prescription drugs covered?
All plans are required to cover prescription drugs, but to confirm your specific medications, check the company's official preferred drug list. We show a link to the official drug list for each plan — look for the Drug List link on Health Plan Radar.
Health Plan Radar is for research purposes only. Estimates shown are based on publicly available information from HealthCare.gov and Medicare.gov. We are not affiliated with the federal marketplace. For official information, visit HealthCare.gov.