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Things to consider before choosing a health plan

From your budget to your lifestyle and your health, here are some things to keep in mind when researching and comparing plans:

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Comparing costs

Let’s say that Tori is a 33 year-old small business owner who lives in the Twin Cities area and purchases her own health coverage. Tori is generally healthy, going to her M Health Fairview doctor once a year for her annual exam and maybe a couple times per year for minor illnesses like strep throat. But this year Tori fractured her arm, so she took a trip to the Emergency Room (ER).

Here are estimates of what Tori’s costs would have been for her fracture under three UCare Individual & Family Plan scenarios using in-network providers:

Overview of 3 plans

  Bronze Silver Gold
*Monthly net premiums $142.60 $185.04 $254.09
Deductible $5,900 $2,900 $900
Specialist copayment $60 $70 $20
Hospital coinsurance 35% after deductible 30% after deductible 20% after deductible

*Premium reflected includes subsidies available through MNsure as well as pricing available in this region and network.

Depending on the plan Tori had, in this example she would pay:

  Bronze Silver Gold
Deductibles $2,500 $1,700 $900
Copayments $200 $40 $600
Coinsurance $0 $0 $100
Total Tori would pay $2,700 $1,740 $1,600

This example situation includes services like: Ambulance, emergency room care (including medical supplies), diagnostic test (x-ray), durable medical equipment (crutches) and rehabilitation services (physical therapy).

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