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Silver Plans

Silver plans balance your monthly premium with what you pay when you get care. Plus, if you qualify based on your income, an Enhanced Silver plan can lower what you pay at the doctor, pharmacy and hospital.

Is Silver right for you?

Silver is the middle among Covered California's plans. Your and what you pay for care both land in the middle — higher than Bronze, lower than Gold or Platinum.

A Silver plan covers about 70 percent of your medical costs, and you pay up to 30 percent. But Silver offers something no other level does: depending on your income and household size, you may qualify for an plan that can cover even more — up to 94 percent — lowering your .

A Silver plan may be a good fit if you:

  • Visit the doctor a few times a year and sometimes see a specialist.
  • Need prescriptions occasionally.
  • Want a balance — a mid-range cost for your monthly premium, and when you get care.

You may want to consider other coverage levels if you:

  • Rarely use health care.
  • Want the lowest possible monthly premium.
  • Use your plan often and want the lowest costs for care, even with a higher premium.

Compare all coverage levels to find the right fit.

Plan types: HMO, PPO and EPO

You've picked Silver. That sets your overall costs. Now pick a plan type: HMO, PPO or EPO. Your choice changes how you see doctors, whether you need a referral and what you pay each month.

  • HMO Plans

    Health maintenance organization

    Lower cost, more structure

    • Only covers in-network care, except for emergencies
    • Need a referral to see a specialist
    • Usually the lowest monthly premium

    BEST FOR

    Lower costs, with a primary doctor managing your care

  • PPO Plans

    Preferred provider organization

    More choice, higher cost

    • See doctors in or out of the network
    • No referral needed to see a specialist
    • Higher monthly premium than HMO or EPO

    BEST FOR

    Flexibility to choose your own doctors and hospitals

  • EPO Plans

    Exclusive provider organization

    Part HMO, part PPO

    • Only covers in-network care, except for emergencies
    • No referral needed to see a specialist
    • Costs usually land between HMO and PPO

    BEST FOR

    Lower costs without needing referrals

You might pay even less for Silver.

If your income qualifies, an Enhanced Silver plan lowers what you pay out of pocket for care — sometimes by a lot. Answer a few questions to see if you qualify and what you'd pay.

Shop and CompareSee Income Limits

What You’ll Pay

There are two kinds of help available with Silver plans:

  • Help with your monthly premium: Most people qualify for Silver plans, including Silver 70, that lower what you pay each month.
  • Help with what you pay for care: Included only with Enhanced Silver plans (73, 87 and 94). Lowers your , and .

Anyone can choose a Silver 70 plan. The lower your household income, the more help you may get with your care costs — some with Silver 7​​3, more with 87, most with 94. When you apply, we'll tell you if you qualify for an Enhanced Silver plan and, if so, for which one. You can also check the income limits chart (PDF) to get an idea before you apply.

Care Costs

Service
Service
Silver 70
Silver 73
Silver 87
Silver 94
Out-of-pocket max individual
$9,800
$8,100
$3,350
$1,400
Out-of-pocket max family
$19,600
$16,200
$6,700
$2,800
Medical deductible individual
$5,200
$5,200
$1,400
None
Medical deductible family
$10,400
$10,400
$2,800
None
Doctor visit
$50
$50
$15
$5
Specialist visit
$90
$90
$25
$8
Urgent care
$50
$50
$15
$5
Emergency room
$400
$400
$200
$50
Lab tests
$50
$50
$30
$10
X-rays & diagnostic imaging
$95
$95
$50
$10
CT/PET scans, MRIs
$325
$325
$100
$50

Prescription Costs

Standard table
Stub Header
Silver 70
Silver 73
Silver 87
Silver 94
Pharmacy deductible individual
$50
$50
$50
None
Pharmacy deductible family
$100
$100
$100
None
Generic (Tier 1)
$19
$19
$8
$3
Preferred (Tier 2)
$60
$55
$25
$10
Non-preferred (Tier 3)
$90
$85
$45
$15
Specialty (Tier 4)
20% up to $250
20% up to $250
15% up to $150
10% up to $150

Common Questions

Ready to compare plans?

See plans available in your area. Compare monthly premiums, doctors, hospitals, prescription costs and estimated savings.

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Keep exploring

Not ready to pick a plan yet? Here are a few ways to learn more or get help.

  • Health Plan Coverage Levels

    No matter which level you choose, the basics are covered, like doctor visits, prescriptions and mental health care. Find your fit.

  • What is Financial Help?

    Most Californians get help paying for their plan. See how savings work and who’s eligible.

  • Find Free Local Help

    Picking a plan can feel overwhelming. 11,000 enrollers are here to answer your questions and help you apply at no cost.