Definition
The percentage of total average costs for covered benefits that a health plan pays. ACA metal tiers are based on actuarial value: Bronze (60%), Silver (70%), Gold (80%), Platinum (90%). A plan with 80% actuarial value pays 80% of costs on average; you pay 20%.
Related Terms
- Deductible
The amount you must pay out of pocket for covered healthcare services before you...
- Copay
A fixed amount you pay for a covered healthcare service after you have met your ...
- Coinsurance
Your share of the costs of a covered healthcare service, calculated as a percent...
- Out-of-Pocket Maximum
The most you have to pay for covered services in a plan year. After you spend th...
- Premium
The amount you pay each month for your health insurance coverage, regardless of ...
Understanding healthcare terminology helps you communicate more effectively with providers and make informed decisions about your care. Use our procedure cost database to find fair prices for any medical service.