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Comparing health insurance plans

How to compare individual and family health insurance plans

When buying a health insurance plan, there are a lot of things to consider. We’re here to help you learn the basics about health insurance plans and costs so you can find a plan that works best for you.

What to consider when comparing health insurance plan costs

When comparing plan costs, there’s more to think about than just your monthly premium. There are other out-of-pocket costs to consider as well.

Generally, the higher your premium, the lower your out-of-pocket costs. Out-of-pocket costs may include:

  • Deductible – This is the amount you pay for covered medical care before your plan starts to pay. Before you meet your deductible, you’re responsible for all costs (unless otherwise noted). After you meet your deductible, your plan starts to help pay for your medical care.
  • Copays – These are flat fees you pay each time you receive a service or procedure.
  • Coinsurance This is a percentage of the total cost you pay for care, and your plan covers the rest.
  • Out-of-pocket maximum – This is a set amount and the most you’ll pay in a year. When you reach your out-of-pocket maximum, your insurance takes care of all remaining medical costs.

In addition to understanding health insurance terms, it’s also a good idea to check if you may be eligible for extra savings – like tax credits. You can take advantage of these opportunities to lower the cost of your plan by shopping for coverage on your state’s health insurance marketplace (also called an exchange).

Most plans have three levels: gold, silver and bronze. Plan levels are based on monthly premium costs and how often you expect to use your plan.

When choosing a plan level, there are a lot of factors to consider: Do you plan to visit the doctor frequently or just a few times a year? Would lower monthly premiums but higher care costs fit your budget? Whether or not you’ve purchased insurance before, think about how you see yourself using your plan as you compare plan levels. Below, we’ll cover the basics.

Gold plans

With gold plans, your insurance carrier pays around 80% or more of your costs, and you pay at most the remaining 20%. Monthly premiums tend to be higher with gold plans. But when you need care, you’ll pay less for it than with other plan levels.

A gold plan might work for you if:

  • You have health conditions that need ongoing management and anticipate needing richer insurance coverage
  • You expect your family to visit the doctor frequently

Silver plans

With silver plans, your insurance carrier pays around 70% of your costs, and you pay the remaining 30%. These plans fall in the middle of the other levels – you pay a moderate amount when you receive care, and you pay moderate monthly premiums. Plus, if you enroll in a plan on the marketplace, you can see if you’re eligible for a cost-sharing reduction (CSR) in addition to tax credits.

A CSR is a discount that lowers costs for copayments, coinsurance and deductibles. It’s available only with silver-level plans on the marketplace.

A silver plan might work for you if:

  • You’re not sure what your health care needs will be, but you want more than basic coverage
  • Your family visits the doctor a few times per year

Bronze plans

With a bronze plan, your insurance carrier pays about 60% of your costs, and you pay the remaining 40%. While this level typically has the lowest monthly premiums, you’ll pay more than the other levels when you need care.

A bronze plan might work for you if:

  • You only want protection from a serious unexpected illness or injury
  • You’re looking for a more budget-friendly option because you don’t expect to visit the doctor very often

What to remember about insurance plan levels

Here’s a summary of the most important takeaways about insurance plan levels. Keep these things in mind as you start to shop different plans:

Gold Silver Bronze
Your monthly premium Higher Moderate Lower
Your costs when you get care Lower Moderate Higher
Could work for you if You think you’ll use your health insurance a lot You’re not sure how much you’ll use your health insurance, but you want to be prepared You don’t think you’ll use your health insurance very much (like only in an emergency)

More plan types

An HSA is a savings account that allows you to put money aside and withdraw it tax free for certain health care costs, like deductibles and copays. You can contribute to an HSA when you’re enrolled in a high-deductible health plan (HDHP), a type of plan where monthly premiums are lower but you pay more when you need care.

A Catastrophic plan is for people under 30 years old, or people who are over 30 years old and have an Affordability or Hardship Certificate of Exemption . A Catastrophic plan usually has the lowest monthly premium and the highest yearly deductible. This type of plan may be a good choice if you’re very healthy and only want a very basic level of health insurance protection.

Our highly rated plans are also available on the health insurance marketplaces in Minnesota and Wisconsin. You may qualify for a tax credit to help lower the cost of your plan.