Many people are familiar with the Bronze, Silver, Gold and Platinum plans, but the lesser known “Minimum Coverage Plan” has some hidden assets for those in certain situations. The Minimum Coverage plan usually has the least expensive premium with the highest deductible and is mostly a catastrophic plan that protects you from “worst-case scenarios”. What many people don’t know is that it offers some free services that can make this plan quite attractive to those on a tighter budget and who normally don’t use very many medical services. The highlights of this plan are below:

• It is available to people who are under age 30.*
• This plan does not qualify for a subsidy through Covered California. You would be paying the full price for this plan. If you qualify for premium assistance, you may pay less for a Bronze Plan.
• This plan includes free preventative care.
• This plan also includes 3 free primary care office visits (in-network only) per person per year that are in-network only.
• This plan has a $8,150 individual deductible and $16,300 on a family basis. This means you pay full cost for all your medical services until or if you meet the deductible.
• The out of pocket maximum is $8,150 for an individual and $16,300 for a family. Once your deductible has been met, your out of pocket is also met, and your insurance kicks in at 100% for all in-network services until the end of the calendar year.

Is the Minimum Coverage Plan Right for Me?

The most important consideration for the Minimum Coverage plan is whether or not you qualify for a premium tax credit. View Covered California income limits to determine this.

If you do not qualify for a subsidy, then this plan might fit your needs best in the following situations:

• You are under age 30.*
• You are comfortable with a high deductible plan.
• You are in good health and typically use very few medical services in a year.
• Your goal is to comply with the Individual Mandate, avoid the penalty and get health insurance in the cheapest way possible.
• You are seeking a child only plan.**

Minimum Coverage Plan vs. Bronze 60 plan

When comparing these 2 plans, the main factors are the premium cost, the 3 free primary care office visits a year, and the deductible. The Minimum Coverage plan usually wins on premium cost, and, since the first 3 primary care visits a year are free, it gives better benefits than the  Bronze 60. But the Bronze 60 plan will save you $300 for an individual if you experience unexpected high medical costs and you meet your deductible. Also, you may qualify for premium assistance if you choose the Bronze Plan.

On the Minimum Coverage plan, you can save around $30/month depending on age, area, and insurance carrier. Generally, the older you are, the more cost savings you’ll see on the Minimum Coverage plan compared to the regular Bronze 60 plan. Also, if you live in an area that has a higher cost of living, you are going to see larger savings in premiums with the Minimum Coverage Plan over the regular Bronze 60 Plan.

A Little More to Think About

Some people express concern about having the money to pay the $7,1500 individual deductible should something major happen during the year. Not to worry, many of the carriers have payment plans but you need to ask about it as they may not bring it up unless you do.