Covered California Metal Levels Explained - Watch on YouTube
Every Covered California plan is sorted into a metal tier — Bronze, Silver, Gold, or Platinum — based on how much of your medical costs the plan covers on average. The metal name isn't about quality of care; it's about how you split costs with the insurer. A higher metal means a higher monthly premium but lower costs when you actually use care.
There's also a special set of enhanced Silver plans (Silver 94, 87, and 73) that give lower-income enrollees much richer coverage at the standard Silver premium. Below is the real 2026 cost-sharing breakdown for every tier, plus straight talk on which one tends to make sense for whom.
Lowest premium, highest out-of-pocket. Best for the healthy who want catastrophic protection and rarely see a doctor.
The benchmark tier. Standard Silver is middle-of-the-road — but if you qualify by income, enhanced Silver (below) is often the best value on the whole market.
Higher premium, low out-of-pocket, and typically no deductible. Strong for people who use regular care.
Highest premium, lowest costs when you use care. Best for those with ongoing or heavy medical needs.
Actual 2026 Covered California cost-sharing by tier. Enhanced Silver (94/87/73) is income-based — see our income limits page to check which you qualify for.
| Benefit | Bronze | Silver | Silver 73 | Silver 87 | Silver 94 | Gold | Platinum |
|---|---|---|---|---|---|---|---|
| Avg. cost covered | 60% | 70% | 73% | 87% | 94% | 80% | 90% |
| Medical Deductible (ind.) | $5,800 | $5,200 | $5,200 | $1,400 | None | None | None |
| Out-of-Pocket Max (ind.) | $9,800 | $9,800 | $8,100 | $3,350 | $1,400 | $9,200 | $5,000 |
| Primary Care Visit | $60* | $50 | $50 | $15 | $5 | $40 | $15 |
| Specialist Visit | $95* | $90 | $90 | $25 | $8 | $70 | $30 |
| Emergency Room | 40%* | $400 | $200 | $50 | $50 | $350 | $175 |
| Generic Drugs (Tier 1) | $20* | $19 | $19 | $8 | $3 | $18 | $9 |
* Bronze applies its deductible/full cost first for many services (after the first 3 non-preventive primary care visits). "None" deductible means covered services start paying immediately. Figures are the standard 2026 Covered California patient-centered benefit designs; specific plans and carriers may vary slightly.
If your income qualifies you for Silver 94 or Silver 87, it's usually the strongest value on the entire market. Look at the numbers above — a Silver 94 plan has a $5 primary care visit, an $8 specialist, and a $1,400 out-of-pocket max, all at the standard Silver premium (which your subsidy often covers most of). That's better cost-sharing than a Platinum plan, for a Silver price.
Many people default to Bronze for the low premium without realizing they'd qualify for enhanced Silver that covers far more. This is one of the most common (and expensive) mistakes we help people avoid — and it takes about two minutes to check.
You're healthy, rarely use care, want the lowest premium, and mainly want protection from a major medical event. Just confirm you don't qualify for enhanced Silver first.
Your income qualifies. This is often the best overall value — low premiums (after subsidy) AND low out-of-pocket. Don't leave this on the table.
You use regular care, want no deductible and predictable copays, and don't qualify for enhanced Silver. Often a better real-world value than standard Silver for frequent users.
You have ongoing or significant medical needs and want the lowest costs at the point of care, accepting a higher monthly premium.
The right tier depends on your income, your doctors, your prescriptions, and how often you use care — not just the premium. We compare all of this side by side, for free. See your actual plans and prices with a free quote, or check your income limits to see if you qualify for enhanced Silver.