Types of Qualified Health Plans (QHP) on the Marketplace

A Qualified Health Plan (QHP) is a health plan that's certified by the Health Insurance Marketplace and DIFS. QHPs provide essential health benefits, follow established limits on cost-sharing (like deductibles, co-payments, and out-of-pocket maximum amounts), and meet other requirements under the ACA.

QHPs are divided into five metal levels. Each metal level represents how the cost for health care services are split between you and the health plan.

The five metal levels are: platinum, gold, silver, bronze, and expanded bronze. Insurers selling health plans on the Marketplace are not required to offer plans in every metal level or in all counties.

  • Platinum Level - These plans must cover 90 percent of expected health care costs and you are financially responsible for the remaining 10 percent.
  • Gold Level - These plans must cover 80 percent of expected health care costs and you are financially responsible for the remaining 20 percent.
  • Silver Level - These plans must cover 70 percent of expected health care costs and you are financially responsible for the remaining 30 percent.
  • Bronze Level - These plans must cover 60 percent of expected health care costs and you are financially responsible for the remaining 40 percent.
  • Expanded Bronze Level - These plans must cover between 56% and 62% of expected health care costs.
    • If an expanded bronze plan covers and pays for at least one major service, other than preventive services, before the deductible, or meets the requirements to be a high deductible health plan, it must cover between 56% and 65% of expected health care costs.