Understanding Bronze Plan Health Insurance

A Bronze plan is a type of health insurance plan offered through the Marketplace, established by the Affordable Care Act (ACA), also known as Obamacare.

The Health Insurance Marketplace uses metal levels to categorize health insurance plans and provides consumers with a range of coverage options. The four metal levels include Bronze, Silver, Gold, and Platinum.

Bronze plans are considered high-deductible health plans (HDHPs), as they typically have the lowest monthly premiums, but the highest out-of-pocket costs for healthcare.

Key Features of an ACA Bronze Plan

Key features of a Bronze plan include:

1. Premium: Bronze plans typically have the lowest monthly premiums, the amount you pay each month for coverage. This can make them an attractive option for individuals and families who use few medical services and are in need of protection from high costs if they were to get seriously sick or injured.
2. Deductible: Bronze plans usually have the highest deductible, which is the amount you must pay out-of-pocket before your insurer starts to make payments for covered medical services.
3. Cost sharing: Once you have met your plan’s deductible, you share the cost of healthcare with your insurer. The Bronze plan’s cost-sharing structure means the consumer pays 40% for the cost of care, and the insurer pays 60%.
4. Out-of-pocket maximum: The out-of-pocket maximum a consumer would be responsible to pay for healthcare each year varies depending on the specific plan and insurer. However, under the ACA, there are annual limits on the in-network, out-of-pocket maximum for health plans, including Bronze plans. These limits are adjusted annually. Healthcare.gov states that for the 2024 plan year, “the out-of-pocket limit for a health plan through the Marketplace cannot be more than $9,450 for an individual and $18,900 for a family.” 1

What Does a Bronze Plan Cover?

All metal level plans, including Bronze plans, must cover essential health benefits mandated by the ACA, including:

• Ambulatory patient services (outpatient care received without being admitted to a hospital)
• Emergency services
• Hospitalization (surgery and overnight stays)
• Pregnancy, maternity, and newborn care
• Mental health and substance use disorder services, including behavioral health treatment (includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative services and devices (used to help regain or recover mental and physical skills due to injuries, disabilities, or chronic conditions)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care for children

While all Marketplace plans provide essential health benefits, you can also select plans through your insurer that include coverage like dental and vision insurance.

In addition to the essential health benefits, some Bronze plans include additional enhanced benefits like $0 select prescription drugs and $0 virtual visits. The specific covered healthcare services can vary depending on the plan.

Review the details of the Bronze plans offered in your state by the insurers you're considering. Plans and insurers may provide access to a different network of doctors and hospitals for care.

How Much Does a Bronze Plan Cost?

The cost of a Bronze plan can vary depending on several factors, including your age, location, family size, and tobacco use.

While Bronze plans are not eligible for cost-sharing reductions (CSRs), individuals who qualify for premium tax credits income can apply those subsidies to help reduce or eliminate their monthly premium.

It's important to consider your healthcare needs and budget when reviewing a Bronze health plan. Be sure to compare the costs and benefits of the different metal levels to make an informed decision for you and your family.

Benefits of a Bronze Plan

As you’re considering health coverage, understanding the potential advantages of a Bronze plan may help as you compare options:

• Lowest monthly premium
• Coverage for essential health benefits
• Savings for those with fewer annual healthcare needs

Who Should Consider a Bronze Plan?

A Bronze health plan can be a suitable option for certain individuals or families depending on their healthcare needs and financial situation. Here are some situations where a Bronze plan may be a good choice:

Healthy individuals and families: If you are generally healthy with no chronic conditions, and do not anticipate needing frequent medical services or prescription medications, a Bronze plan can be a cost-effective option. The lower monthly premium can provide savings, and you can still have coverage for unexpected healthcare needs or emergencies.

Those with a budget consideration: If you have a restricted budget and need to minimize your monthly healthcare expenses, a Bronze plan may be a good choice. The lower premium can help you save money, especially if you are willing to take on higher deductibles and out-of-pocket costs when seeking medical care.

Consider your specific healthcare needs and financial situation when deciding on a health insurance plan. If you anticipate needing regular medical care or have ongoing health conditions, it may be worth exploring a higher-tier plan, such as a Silver or Gold plan.