How to select your UCare Choices plan

Transcription

1 How to select your UCare Choices plan

2 It s time to shop! We know finding the right health insurance plan can be overwhelming. That s why we created this shopping guide to walk you through the process. From what questions to ask, to understanding insurance terms, to choosing the right level of coverage, we re here to help. You decide what s most important: a larger network of doctors, clinics, hospitals and pharmacies; a lower monthly premium; or maximum protection. Whatever your priorities, UCare Choices has a plan to meet your needs.

3 Getting started 1. CHECK THE NETWORK AND SERVICE AREA Who s in the network? You can search the network at ucare.org to find doctors, clinics, pharmacies and more that are part of UCare s network. Choosing a smaller network such as Fairview UCare Choices is one way to lower your health care costs. What area does the plan cover? Make sure the plan you are interested in is available in your county. This map shows where our UCare Choices and Fairview UCare Choices plans are offered. KOOCHICHING ITASCA ST. LOUIS LAKE COOK CASS CROW WING AITKIN CARLTON MILLE PINE LACS MORRISON KANABEC BENTON STEARNS ISANTI CHISAGO SHERBURNE WRIGHT ANOKA RAMSEY WASHINGTON CARVER HENNEPIN SCOTT DAKOTA UCare Choices UCare Choices UCare Choices + Fairview UCare UCare Choices Choices + Fairview UCare Choices

4 2. DETERMINE THE LEVEL OF COVERAGE YOU NEED If lower monthly expenses are your top priority, consider a plan with a lower premium and higher out-of-pocket costs (s, and copayments). If you would prefer more protection and lower out-of-pocket costs, consider a plan with a higher monthly premium. UCare Choices has different plan levels to meet your needs: a Catastrophic (Core) plan* Bronze level plans: basic coverage with lower monthly premiums and higher out-of-pocket costs Silver level plans: medium level coverage and monthly premiums Gold level plan: higher monthly premiums and lower out-of-pocket costs *To qualify for UCare Choices Core, you must be under 30 years old or get a hardship exemption if MNsure determines you re unable to afford health coverage. 3. CHECK TO SEE IF YOU QUALIFY FOR FINANCIAL SUPPORT Go to the Health Plans page on ucare.org to compare plans for individuals and families and to estimate the amount of support you are eligible for, based on household and income information. If you qualify for a premium subsidy (also known as the Advance Premium Tax Credit or APTC), your tax credit will be applied to the premium of any metal-level plan you choose. You may also qualify for cost sharing reductions (CSR) to lower your and out-of-pocket limit. However, those savings can only be applied to Silver-level plans. Note: UCare Choices Core is not eligible for subsidy support.

5 4. COMPARE PLANS This chart summarizes basic coverage information for UCare Choices and Fairview UCare Choices plans. Compare plans to find levels, copayments and prescription drug coverage that fit your needs. UCare Choices 2018 plan benefit comparison UCARE CHOICES FAIRVIEW UCARE CHOICES CORE BRONZE SILVER GOLD BRONZE SILVER Individual $7,350 $7,050 $2,900 $1,200 $7,050 $2,900 Family $14,700 $14,100 $5,800 $2,400 $14,100 $5,800 Individual out-of-pocket limit Family out-of-pocket limit $7,350 $7,350 $7,000 $4,000 $7,350 $7,000 $14,700 $14,700 $14,000 $8,000 $14,700 $14,000 Office visits/ urgent care $30 for first then $60 for first then 3 $40 for first then 25% after $30 for first then 2 $60 for first then 3 $40 for first then 25% after Retail visits $10 $20 $10 $10 $20 $10 Online visits FREE FREE FREE FREE FREE FREE Generic prescription drugs $25 $12 $10 $25 $12 Brand and specialty drugs Emergency room (in and out of network) $500 for first visit, then 30% and $250 for first visit, then 25% and $250 for first visit, then 20% and $500 for first visit, then 30% and $250 for first visit, then 25% and Diagnostic tests 3 25% after % after Hospital stays 3 25% after % after Note: These costs reflect in-network coverage. People who qualify for cost sharing reductions and Native Americans may pay lower or no costs for the benefits in this grid. Check with MNsure to verify. All plans have an embedded. Changes to premium rates will be made as allowed by state and federal laws. Visit healthcare.gov for more information.

6 5. ESTIMATE YOUR MONTHLY COSTS This worksheet is an easy way to estimate your monthly premium for three different plans. Using the rate sheets online at ucare.org, follow these instructions to compare plans: Determine which UCare Choices plans you d like to compare. Find the rate sheet that applies to your area (Metro area or Northeast) and your smoking status (non-smoker or smoker). On the appropriate rate sheet, find your age. Write down the monthly rate on your worksheet. If applicable, find your spouse s monthly rate in the same way. If applicable, find each of your dependent s rates. Note: You pay for a maximum of three dependents ages 0-20, and all dependents over age 21. Add your monthly rate, your spouse s and your dependents rates to find the total monthly premium for your family. Use the shopping tool at ucare.org to estimate what subsidies may be available to you. EXAMPLE I m a 38-year-old looking for family coverage. My spouse is 36 years old and we have two children under age 20. We are non-smokers and live in the Twin Cities metro area. I d like the UCare Choices Bronze plan. On the chart, my rate is $267.18, my spouse s rate is $ and the rate for each of my two children is $ I add these together and find my monthly premium is $ before subsidies. Plan comparison worksheet Plan Name Your monthly rate Spouse s monthly rate Dependent (Oldest) Dependent (Next oldest) Dependent (Next oldest) Dependent (Next oldest) Total monthly premium Remember, for households with dependents under age 21, you only need to pay a premium for your three oldest. Families with dependents ages will pay age-based premiums for each. If you would like help estimating your household s premium costs, please give us a call. Our experts are here to help.

7 READY TO ENROLL? GO TO MNSURE.ORG BETWEEN NOV. 1 - JAN. 14 For coverage starting Jan. 1, be sure to sign up by Dec. 20. Call us Still have questions? Call a UCare Choices representative Toll Free (TTY) Hours of service: 8 a.m. to 5 p.m., Monday-Friday choices@ucare.org Make the smart choice in heath care AVERAGE COSTS WITHOUT INSURANCE ER VISIT $1,233 BROKEN LEG $7,500 HOSPITAL STAY $30,000

8 UCare Choices Fairview UCare Choices toll free TTY: toll free Hours: 8 a.m. 5 p.m. Monday Friday choices@ucare.org You can count on UCare UCare is a local, non-profit health plan that has been dedicated to serving Minnesotans of all ages and abilities for more than 30 years. UCare is committed to partnering with state and federal agencies to make sure sustainable, affordable coverage is available to Minnesotans for years to come. Learn more at ucare.org. Statement of Nondiscrimination UCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al / (TTY: / ). LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau / (TTY: / ). UC FVC_092517_1 IA ( )