Health Insurance Plan Types Compared: Bronze to Platinum, HMO to HDHP
Choosing the right plan type can save you $200+/month. Here is how every option compares in 2026 with real dollar amounts.
Metal Tier Comparison
ACA plans are grouped by actuarial value: the percentage of average healthcare costs the plan covers.
| Tier | Coverage | Premium | Deductible | PCP Copay | Specialist | Coinsurance | OOP Max |
|---|---|---|---|---|---|---|---|
| Bronze | 60% | $573 | ~$7,500 | $45 | $80 | 40% | $10,600 |
| Silver | 70% | $752 | ~$5,000 | $35 | $65 | 30% | $10,600 |
| Gold | 80% | $793 | ~$1,500 | $26 | $44 | 20% | $10,600 |
| Platinum | 90% | $1,012 | ~$500 | $15 | $30 | 10% | $10,600 |
Catastrophic Plans
Catastrophic plans are available to people under 30 or those with a hardship exemption. They have very low premiums but a high deductible of $10,600 in 2026 (the same as the out-of-pocket maximum).
These plans cover 3 primary care visits per year before the deductible, plus preventive care. New 2026 CMS rules expanded hardship exemption eligibility, making catastrophic plans available to more people who have been priced out of standard marketplace plans after the subsidy cliff.
Catastrophic plans are not eligible for premium tax credits and do not count toward cost-sharing reduction calculations. They are a safety net, not comprehensive coverage.
Network Type Comparison
Network type determines which doctors you can see and how much flexibility you have.
$573-660/mo
Referrals
Required
Out-of-Network
Not covered (except ER)
Pros
- +Lowest premiums
- +Coordinated care
- +Predictable copays
Cons
- -Must pick PCP
- -Referrals needed
- -No out-of-network
$752-870/mo
Referrals
Not required
Out-of-Network
Covered at higher cost
Pros
- +Any doctor, no referral
- +Out-of-network coverage
- +Most flexible
Cons
- -Highest premiums
- -Higher OOP costs
- -Complex billing
$660-760/mo
Referrals
Not required
Out-of-Network
Not covered (except ER)
Pros
- +No referrals
- +Lower than PPO premiums
- +Direct specialist access
Cons
- -No out-of-network
- -Smaller networks
- -Limited for travel
$480-560/mo
Referrals
Varies by plan
Out-of-Network
Varies by plan
Pros
- +Lowest premiums
- +HSA eligible
- +Funds roll over
Cons
- -High deductible ($1,650+)
- -Large bills if sick
- -Requires financial discipline
HDHP + HSA: The Triple Tax Advantage
For healthy individuals and families, a High-Deductible Health Plan paired with a Health Savings Account is the most tax-efficient option available. The HSA provides three tax benefits:
Tax-deductible contributions
Reduce your taxable income by up to $4,300 (individual) or $8,550 (family) in 2026. Add $1,000 catch-up at age 55+.
Tax-free growth
Invest HSA funds in index funds or other investments. All gains grow tax-free, like a Roth IRA but better.
Tax-free withdrawals
Pay for qualified medical expenses tax-free at any time. After age 65, withdraw for any purpose (taxed as income, like a 401k).
2026 HDHP minimums: $1,650 deductible (individual), $3,300 (family). 2026 HSA limits: $4,300 (individual), $8,550 (family), plus $1,000 catch-up at 55+.
Silver Plan + Cost-Sharing Reductions
If your income is between 100-250% of the Federal Poverty Level, a Silver plan is almost always the best choice. Cost-sharing reductions (CSRs) automatically lower your deductible, copays, and out-of-pocket maximum, but only on Silver plans.
| Income Level | Actuarial Value | Effective Deductible | OOP Max |
|---|---|---|---|
| 100-150% FPL | 94% | ~$75 | $2,900 |
| 150-200% FPL | 87% | ~$800 | $3,500 |
| 200-250% FPL | 73% | ~$3,500 | $7,550 |
| Standard Silver (no CSR) | 70% | ~$5,000 | $10,600 |
At 100-150% FPL, a Silver plan with CSRs provides 94% actuarial value, which is better than Platinum. This is the best deal on the marketplace.
Which Plan Is Right for You?
I want the lowest possible premium
HDHP if healthy, Bronze HMO if you need some coverage
I need to see multiple specialists
PPO for max flexibility, EPO if staying in-network is fine
I rarely go to the doctor
HDHP with HSA to save on premiums and build tax-free savings
I have chronic conditions or regular prescriptions
Gold or Platinum PPO or HMO with low deductible
My income qualifies for CSRs (100-250% FPL)
Silver plan, always. CSRs make it the best value
I want tax-free savings for healthcare
HDHP paired with a Health Savings Account