Skip to navigation Skip to content Skip to footer
woman getting blood pressure checked in doctor office

Understanding health insurance coverage

Health insurance offers protection by limiting what you pay out-of-pocket for health care costs when you visit a doctor, go to the emergency room or get a prescription drug. It also includes benefits and programs to stay healthy and live well. All individual and family plans offered in Minnesota must cover 10 essential benefits, such as preventive care, maternity services and mental health services.

Importance of having health insurance

Health insurance gives you peace of mind to know your costs will be limited if you get sick or hurt. Without coverage, you are responsible for the total costs of your health care, which can dig into your savings or leave you in debt.

Simplified health insurance terms

Here are some definitions for common terms you’ll see as you shop for health plans.


Definition: Financial support from the government to lower the cost of your monthly premium and in some cases, out-of-pocket costs. Check to see if you qualify before you enroll. Subsidies for individual and family plans are only available if you sign up for your health plan through MNsure.


Definition: The amount you pay each month to have health insurance.

Copayment or copay

Definition: A copay is a smaller, fixed amount you pay for a doctor visit or prescription drug. For example, many plans only charge a copay for office visits and generic drugs. You don’t have to meet your deductible for these services. Be sure to see in-network providers whenever possible. If you go to a health care provider that is outside of your plan’s network, your out-of-pocket costs will be much higher.


Definition: Your deductible is a set amount that you will have to pay for health care services before your plan starts paying. There are some things that have to be covered at 100% by law, so you don’t have to pay anything for them. Examples include preventive exams like mammograms and blood pressure screenings, birth control drugs and procedures, and immunizations for children. Get more information about preventive care.


Definition: Coinsurance is the percentage you pay after you’ve met your deductible. For example, your plan may pay 80% of a hospital stay, while you’d be responsible for 20%. Your plan also has an out-of-pocket limit. Once you reach that, your plan will cover you at 100%. Again, it’s best to see in-network providers whenever possible to help control your costs.

Levels of coverage

There are four levels of coverage for health plans: catastrophic (core), bronze, silver and gold. The levels are based on how you and your plan share the costs of your medical care.

  • Catastrophic/core plans have the lowest monthly premiums and the highest out-of-pocket costs. You must be under age 30 or obtain a hardship exemption to qualify.
  • Bronze plans have a lower monthly premiums with the highest coinsurance and copayments.
  • Silver plans have mid-level monthly premiums, and mid-level coinsurance and copayments.
  • Gold plans have higher monthly premiums, but lower out-of-pocket costs when you need care.

Not sure which coverage level is best for you? Review information on how to determine which metal level is right for you or talk with a UCare simplifier to determine which plan makes the most sense for your situation.

Ways to get health coverage

In general, there are four ways to get health coverage:

If you do not get insurance through an employer, is where you’ll find out what kind of financial assistance you’re eligible for and enroll in a plan.

spark icon

Learn what to consider when choosing a plan

Your budget, health and lifestyle should all factor into your choice. Let us be your guides.

spark icon

Explore UCare health plans

Learn more about which plan is the best fit for you.

spark icon

Get ready to enroll

See our tips on how to navigate the enrollment process.

Our Individual & Family Plan simplifiers can talk you through your questions.

Call us at 612-676-6606 or 1-855-307-6975
TTY 612-676-6810 or 1-800-688-2534
8am – 5pm, Monday – Friday