How to choose an individual and family health plan

How to choose a health plan: four considerations

Individual and family plans are health plans for people who don't have health insurance through an employer or the government. Understanding the choices available can be overwhelming for many. That's why we've broken down the process of choosing a plan.

Your health is just one factor you need to think about when comparing plans. Below are four key considerations to make when shopping for a health plan.

Your provider network

It's important to find out if your doctors and other health practitioners are in a plan's network before choosing that plan. You'll typically pay quite a bit more if you visit an out-of-network provider.

Health plan companies, including UCare, typically offer care through broad and focused provider networks. A broad network gives you access to a wide variety of care systems and providers while a focused network requires you to see a more limited number of providers in exchange for lower premiums.

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Also check to see if any prescription medication you regularly take is on the plan's drug list, also known as the formulary.

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Your health needs

Review your health conditions to see what care you might need. If you're buying coverage for members of your family, be sure to consider these questions for them, too.

• Do you anticipate any tests, procedures or other major health expenses in the coming year?
• Do you have a chronic health condition that you manage with medication and/or with regular doctor visits?

By understanding your health needs, you can decide what level of coverage is best for you and your family. For example, UCare offers four levels of coverage: Core (catastrophic), Bronze, Silver and Gold. If you choose a lower level, you'll have lower premiums, but you'll pay more out of pocket when you visit the doctor or get a prescription. If you choose a higher level, you'll have higher premiums but lower out-of-pocket costs.

Your budget

Review your budget to see how much you can afford for premiums and expected medical care. This will help you determine which plan type and coverage level to choose.

• Are you eligible for subsidies that could decrease your monthly premium or out-of-pocket costs? Visit our shopping tool or check mnsure.org to see if you qualify.
• Is it easier on your budget to have lower monthly premiums and pay more out of pocket when you receive care, or have higher monthly premiums in exchange for lower costs when you receive care?
• Could you afford the out-of-pocket maximum if you experience unexpected medical needs? (The out-of-pocket maximum is the most you'll pay for covered services and supplies in a year. This amount is different depending on the plan.)
• Are you comfortable with having a smaller provider network in exchange for lower premiums?
• Do you want to start or keep contributing to a health savings account (HSA)?

Additional health plan benefits

Consider any additional benefits that might be offered with your health plan, like:

• Healthy grocery discounts
• One Pass Select fitness and well-being programs
• Car seats
• Rewards for completing your preventive care