Actuarial Value

Valor Actuarial

In 9 languages

LanguageTerm
EnglishActuarial Value
Spanish (Español) Valor Actuarial
Chinese (中文) 精算价值
Korean (한국어) 보험계리 가치
Vietnamese (Tiếng Việt) Giá trị tính toán bảo hiểm
Filipino (Tagalog) Actuarial na Halaga
Portuguese (Português) Valor Atuarial
Thai (ภาษาไทย) มูลค่าตามหลักคณิตศาสตร์ประกันภัย
Japanese (日本語) アクチュアリアル・バリュー

What it means

Actuarial value is the percentage of total covered medical costs that a health plan pays for an average patient. If a plan has an actuarial value of 70%, the insurance company pays 70 cents of every dollar in covered expenses on average, and you pay the remaining 30% through deductibles, copays, and coinsurance. ACA marketplace plans are grouped into metal tiers based on actuarial value: Bronze (60%), Silver (70%), Gold (80%), and Platinum (90%). A higher actuarial value usually means higher monthly premiums but lower costs when you actually use care. Your individual experience may differ from the average depending on your health needs.

How to say it

Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:

The Gold plan has an actuarial value of 80%, so my insurer covers most of my costs.

El plan Gold tiene un valor actuarial del 80%, así que mi aseguradora cubre la mayor parte de mis gastos.

A Bronze plan's lower actuarial value means I pay more when I see a doctor.

El menor valor actuarial de un plan Bronce significa que pago más cuando voy al médico.

I chose the Silver plan for its 70% actuarial value and cost-sharing reductions.

Elegí el plan Silver por su valor actuarial del 70% y las reducciones de costo compartido.

Where you'll see it

Summary of Benefits and Coveragemarketplace plan comparison toolinsurance plan brochurehealthcare.gov enrollment page

Related terms

Sources

US Glossary Español A–Z US Codes United States

Last reviewed: September 2026