Which metal tier health plan should I choose?

How is choosing your health insurance like the Olympics? 

You don’t know what medal is meant for you until it’s over.

Every year people ask me what metal tier they should choose for their health insurance. 

I can’t answer, only they can choose.

Olympics logic suggests that you want to be at the top of the podium, right? 

So Gold? 

Or Platinum, if it’s available. Right?

Not necessarily. 

The metal tiers are more about risk tolerance than coverage:

Lower tier = pay less monthly, but pay more when you go to the doctor

Higher tier = pay more monthly, but pay less when you go to the doctor

Which metal is “right” for you depends on where you bear more risk:

🩻 Health Status

A lower tier is a bet that you won’t go to the doctor very often. It means saving on your monthly bills but risking a big, unexpected expense if you get really sick or have an accident. 

Some people juggle chainsaws as a hobby or go to the doctor every time they get the sniffles. For these people, paying more for the higher tier plan may protect them from big one-time costs.

But for the people who won’t go to the doctor unless they’re unconscious and someone else drags them there, a lower metal tier may be more cost-effective. 

💰 Cost Sharing

If your employer pays for most or all of your premiums, there’s little risk in signing up for the expensive plan. 

If you don’t go to the doctor, you pay nothing. 

If you do go to the doctor, you pay little.

If your employer doesn’t pay for the majority of your and your dependents’ premiums, then you’re at risk for over-insuring. 

If you don’t go to the doctor very often, you’re overpaying to save money on something you’re not using.

But if the deductible on the cheap plan could mean not making rent for a month if you break a leg,

or if the out-of-pocket max could put you into bankruptcy if you have a car accident,

it may be better to pay the higher monthly fee for peace of mind and less financial volatility. 

Or we could all just move to Canada. That might not be so bad... 

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