Choosing a Health Insurance Plan

Health insurance plan comparison starts with premiums but shouldn't end there. The cheapest monthly premium often isn't the cheapest plan overall — your total cost depends on how much healthcare you actually use.

Understanding the metal tiers

Bronze plans have the lowest premiums but highest out-of-pocket costs. They cover about 60% of costs on average. Silver plans cover about 70%, Gold covers 80%, and Platinum covers 90%. The tier you should choose depends on how much healthcare you expect to use.

Total cost analysis

Consider the Martinez family: household income $110,000, two adults and one child. A Silver plan costs $850/month with a $4,000 deductible and $12,000 out-of-pocket maximum. A Gold plan costs $1,050/month with a $1,500 deductible and $8,000 OOP max.

If the family uses minimal healthcare (2 doctor visits each, prescriptions): Silver total cost = $10,200 premiums + $600 copays = $10,800. Gold total cost = $12,600 premiums + $200 copays = $12,800. Silver wins by $2,000.

If someone needs surgery ($25,000 billed): Silver total cost = $10,200 premiums + $12,000 OOP max = $22,200. Gold total cost = $12,600 premiums + $8,000 OOP max = $20,600. Gold wins by $1,600.

The crossover point is somewhere in between. If you're generally healthy, a lower-tier plan usually saves money. If you expect significant healthcare use, a higher-tier plan with lower out-of-pocket limits may be cheaper overall.

HSA-eligible plans

High-deductible health plans (HDHPs) paired with Health Savings Accounts offer a powerful tax advantage. HSA contributions are tax-deductible, grow tax-free, and can be withdrawn tax-free for medical expenses — a triple tax benefit that no other account type offers.