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Pedal to the metal: How picking a health plan is like picking a car

Whether you’re shopping for a new car or a new health plan, you’ve got to balance your taste, your needs and your budget. Here are your options where the rubber meets the road.


By Kate Awsumb
July 27, 2017

     


When you’re shopping for a new car, you might start with a make you like. Depending on your budget and the features you want, you have to narrow it down to a specific model in the lineup. Health plans have different models, too.

From bronze to platinum, the health plan level – or metal level – you choose affects:

  • How much you pay each month (your premium)
  • How much you pay when you visit the doctor, fill a prescription or get other care

Plans where you pay less each month typically mean bigger bills when you use care, while paying more each month means less coming out of your wallet for care.

Here are your options where the rubber meets the road:

Platinum: think of this plan as the souped-up, vintage throwback muscle car with all the extras

Best if:

  • You expect to visit the doctor six or more times per year.
  • You need regular prescriptions.
  • You’re comfortable paying more each month and want lower costs when you get care.

What you pay each month (premium):

$$$$$

What you pay for care:

Your health plan pays 90% on average. You pay about 10%.

Gold: Think of this plan as the straight-up sports car

Best if:

  • You expect to visit the doctor six or more times per year.
  • You need regular prescriptions.
  • You’re comfortable paying more each month and want lower costs when you get care.

What you pay each month (premium):

$$$$

What you pay for care:

Your health plan pays 80% on average. You pay about 20%.

Silver: Think of this plan as the sporty coupe

Best if:

  • You expect to visit the doctor three or fewer times per year.
  • You’d rather pay a little more each month and less when you get care.

What you pay each month (premium):

$$$

What you pay for care:

Your health plan pays 70% on average. You pay about 30%.

Bronze: Think of this plan as the compact sedan

Best if:

  • You’re pretty healthy and you don’t expect to visit the doctor much.
  • You want protection against major illnesses or accidents.
  • You’d rather pay less each month and more when you get care.

What you pay each month (premium):

$$

What you pay for care:

Your health plan pays 60% on average. You pay about 40%.

Catastrophic: Think of this plan as the rent-it when you need it car

Best if:

  • You’re 18 to 29 years old or have what’s called a hardship exemption.
  • You’re very healthy and only need protection against major illnesses or accidents.
  • You’d rather pay a little each month and higher costs when you get care.

What you pay each month (premium):

$

What you pay for care:

Your health plan pays less than 60% on average. You pay the rest.

Health plans aren’t one-size-fits-all – and finding a great fit for your family is important. Talk to someone who can help match your unique needs with the plan that suits you best.

About Kate Awsumb

Kate Awsumb is a journalist and communications consultant for HealthPartners who has worked with many government, nonprofit, and private organizations to make health information easy to understand and easy to use. Her writing has been featured in the Huffington Post, Men’s Health, StarTribune, Minnesota Parent and the Twin Cities Moms Blog. She holds master’s degrees in health communication and public health, making her a perfect fit for the Health Insurance Help blog. Kate believes health is so much more than not being sick – it keeps us doing what we love, traveling to new places and chasing our kids around the backyard. When she’s not working, you’ll find Kate running, hiking, biking, rowing, snowshoeing, or otherwise on the move with her husband, young daughter and Boston terrier.

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