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Bronze Healthcare Exchange Plan Explained

May 14, 2013

By Amy De Vore+

What Is the Bronze Plan?

The Patient Protection and Affordable Care Act, AKA Obamacare, will offer 4 new insurance plans called Bronze, Silver, Gold, and Platinum starting January 1, 2014. In a recent survey only 4% of Americans understood the difference between the plans, one of the most important facts of the new plan is all plans must cover the same Healthcare Exchange essential benefits, however each state and/or provider may offer additional or extended benefits. The Bronze Plan is set up to have the lowest monthly premium of the 4 new categories of plans*, with the highest out-of-pocket costs (combination of deductible, copayment, and coinsurance).

*There is also Healthcare Exchange Catastrophic coverage, only available to those under thirty and available to those who are unable afford one of the standardized plans.

Bronze Plan Image

How do Bronze Plans work?

The following information below is for individual and family members. Click here to learn about how the Bronze plan works for Small Business owners under ObamaCare.

• 60/40 split, with you paying 40% for healthcare expenses
• Deductibles expected to be around $5,000
• Lowest monthly premium (without subsidies). Do I qualify for Healthcare Exchange subsidies?

Benefits Bronze Health Plan*
Deductible $5,000 Med/Rx
Preventive $0
Doctor’s Office Visits $60 per first 3
Specialist $70 *after deduct
Generic Rx $19 *after deduct
Brand RX $50 *after deductible
Lab Testing 30% *after deduct
X-ray 30% *after deduct
Maternity 30% *after deduct
Out-patient Surgery 30% *after deduct
Hospital Stay 30% *after deduct
ER Visit $300 *after deduct
Urgent Care $120 *after deduct
Out-of-Pocket Max $6,350/$12,700 (ind/fam)

*California was the first to release its Healthcare Exchange details and much of the copay information we know so far are based on their figures. CHART UPDATED 9/26/13. For information about specific details of the Bronze health plan in your state call 800-930-7956.

UPDATE 11/27/13: For an easy way to fill out your Affordable Care Act application go to Remember to fill it out and send it in as soon as possible to ensure the earliest enrollment date.

Is There Only One Bronze Deductible?

No, Bronze offers different plans with high and low deductibles (the amount you pay before your insurance kicks in) and different amounts of co-insurance (% you pay after deductible is satisfied, and before out-of-pocket max is met). Remember, regardless of the deductible, all Bronze plans will ultimately equal that 60/40 split.

Seniors and the Healthcare Exchange

Just a reminder that people over 65 do not have the same options. Click here to learn more about Seniors and the Health Care Exchange.

How Does the Bronze Health Plan Compare to the Other New Plans?

Basically Bronze will cost you the least each month but you will pay the most in shared costs should you get injured. Click here to compare Bronze Plan, Silver Plan, Gold Plan, and the Platinum Plan side-by-side.

For any questions or assistance in applying (enrollment goes from October 1, 2013 to March 31, 2014),  please contact Medicoverage.


Open enrollment for new health coverage begins Nov 15, 2014. Applications must be submitted before Feb 15,2015. Apply for an ACA Plan Here


Comments for Bronze Healthcare Exchange Plan Explained

By John Lee on June 20, 2013

This is really helpful. Only thing is how much will the monthly premiums be for this plan?


Great Question John,
Since open enrollment for these plans do not begin until October we will not know the exact price for a little while. Each company that offers a bronze plan in your state can do so at a different rate so it will be important to comparison shop.  We will post up here as soon as we get the rate sheets from the bronze plan providers. If you have any questions once prices are published, give us a call at 800-930-7956
-Eric from

By Michael F. Morrissey on October 14, 2013

If you have a $5,000 deductible, the insurance does not kick in until the $5,000 deductible is satisfied. TRUE ?

I read in the NYT that the maximum out-of-pocket medical expenses of $6,350 for an individual and $12,700 for a family have been postpned until 2015. TRUE ?


Thanks so much for your questions. Depending on which plan you purchase, your insurance benefits may not kick it to pay for covered expenses until till after your deductible is met. Out of pocket Maximums (OPM) can vary but the Bronze, Gold and Silver typically have $6,350 OPM for individual and $12,700 OPM for family.

As far as we can tell from the NYT article and the states we represent, the change in the OPM should only affect group insurance. But as you can tell, plan specifics are still being clarified.

We suggest giving it a little time to settle before you enroll in a new plan. Don’t forget you can enroll in an ACA plan until December 15th for a January 1st start date. Please give us a call at 800-930-7956 and we would be glad to help you sign up.
-Kelly from

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