Covered California
Covered California Silver 70 vs. 73 vs. 87 vs. 94 for 2027
Covered California offers four Silver plan designs for 2027: Silver 70, Silver 73, Silver 87 and Silver 94. They cover the same categories of essential health benefits, but the deductible, copays and annual out-of-pocket limit can be very different. Silver 73, 87 and 94 are Enhanced Silver plans available when an applicant qualifies for cost-sharing reductions.
The amounts below come from Covered California’s final approved 2027 Patient-Centered Benefit Plan Designs, dated June 18, 2026. They show the standard individual member cost share; actual premiums, plan availability, networks and eligibility depend on the complete application and selected insurer.
2027 Silver 70, 73, 87 and 94 comparison
| 2027 individual benefit | Silver 70 | Silver 73 | Silver 87 | Silver 94 |
|---|---|---|---|---|
| Medical deductible | $4,700 | $0 | $0 | $0 |
| Pharmacy deductible | $50 | $0 | $0 | $0 |
| Annual out-of-pocket maximum | $11,650 | $6,100 | $3,000 | $1,150 |
| Primary care visit | $50 | $35 | $15 | $5 |
| Specialist visit | $100 | $85 | $25 | $8 |
| Urgent care | $50 | $35 | $15 | $5 |
| Emergency room facility fee | $400 | $350 | $150 | $50 |
| Tier 1 prescription | $20 | $15 | $5 | $3 |
| Tier 2 prescription | $65* | $55 | $25 | $10 |
*For Silver 70, the pharmacy deductible applies to Tier 2 and Tier 3 prescriptions. This table highlights common services and is not a complete Summary of Benefits and Coverage. Family deductibles and out-of-pocket limits are different.
What do the Silver numbers mean?
The number reflects the plan’s approximate actuarial value—not the percentage the plan pays for every individual service. Silver 70 is the standard Silver design. Silver 73, 87 and 94 provide progressively stronger cost-sharing reductions for eligible households, generally resulting in lower deductibles, copays and out-of-pocket limits.
Covered California’s final 2027 design labels Enhanced Silver 94 for the 100%–150% federal poverty level range, Silver 87 for 150%–200%, and Silver 73 above 200%. Covered California’s consumer guidance explains that Enhanced Silver assistance may extend through 250% of the federal poverty level. Medi-Cal rules, household details and other eligibility factors can affect the result, so use the eligibility result shown on the application rather than assigning yourself a plan from income alone.
Premium help and Enhanced Silver are not the same benefit
A premium tax credit or state subsidy lowers the monthly premium. Cost-sharing reductions lower what an eligible member pays when receiving care, including deductibles, copays, coinsurance and the out-of-pocket maximum. Cost-sharing reductions are available only when the eligible applicant selects an Enhanced Silver plan. Someone may qualify for monthly premium help without qualifying for Silver 73, 87 or 94.
When can an Enhanced Silver plan be valuable?
- You expect regular primary care, specialist or behavioral-health visits.
- You use prescriptions throughout the year.
- A lower annual out-of-pocket maximum would provide important financial protection.
- You qualify for Silver 87 or Silver 94, which substantially reduce common service costs.
Do not compare only the monthly premium. A Bronze plan may have a lower premium but expose the household to more cost when care is used. Conversely, a household that does not qualify for Enhanced Silver should compare Silver 70 with Bronze, Gold and other available plans based on expected total yearly cost.
Four checks before selecting a 2027 Silver plan
- Confirm eligibility: Update projected 2027 income and household information.
- Check the network: Verify doctors, hospitals and medical groups for the exact plan.
- Check prescriptions: Review the formulary, tier and any prior authorization or quantity limit.
- Compare total cost: Consider premium, deductible, copays and the maximum financial exposure.
Common questions
Is Silver 94 always more expensive than Silver 70?
Not necessarily. Silver 94 is an Enhanced Silver benefit level based on eligibility; it is not simply a richer plan that anyone can buy at a higher price. The monthly premium after financial help and the available plan choices must be checked through the application.
Do all Silver plans use the same doctors?
No. The standard cost-sharing design does not make carrier networks identical. Verify the provider directory for the exact insurer, product and region.
Can my Silver level change at renewal?
Yes. Changes in projected household income, household members or program rules can change eligibility. Review the renewal notice and update the application before selecting a 2027 plan.
Compare your 2027 options with Skyline Benefit
Skyline Benefit can help California individuals and families compare Silver benefits, available carriers, provider networks, prescriptions and total costs. Call (714) 888-5112 or request a consultation. Final eligibility, premiums and benefits are determined by Covered California and the applicable plan documents.