Open enrollment for 2021 is quickly approaching, making the next few weeks an opportune time to assess the available health insurance options. Concerning individual and family plans available on the exchange, there are four different metal tiers of insurance coverage, starting with bronze which offers the lowest level of cost-sharing.
In this article, we are going to focus our attention on this metal tier specifically.
What Are Bronze Health Insurance Plans?
Bronze health insurance plans are designed to cover a lower proportion of your medical costs, and as a result, they have lower monthly premiums. However, they have significantly higher deductibles as a consequence. Bronze plans are designed to cover around 60% of your medical costs on average, with you picking up the remaining 40%.
Is a Bronze Plan the Right Fit for Me?
Being on the bottom rung of health insurance plans, bronze plans are best-suited to those who are young, fit, and healthy. They are a good option for those of you seeking protection from worst-case medical scenarios. However, you‚ll have to pay full price for the vast majority of routine care.
You can learn more about which health insurance plans are best-suited to you with our useful health insurance guide.
Empire BlueCross BlueShield Bronze vs. UnitedHealthcare Bronze
|Benefits||Empire BlueCross BlueShield Bronze||UnitedHealthcareCompass Bronze|
|Available on Exchange||Yes||Yes|
|No referral needed for specialist||❌||❌|
|Preventative care||$0 pre-deductible.||$0 pre-deductible.|
|Primary care||50.00% coinsurance after deductible.||50.00% coinsurance after deductible.|
|Specialty visits||50.00% coinsurance after deductible.||50.00% coinsurance after deductible.|
|Urgent care||50.00% coinsurance after deductible.||50.00% coinsurance after deductible.|
|Prescription drug deductible||$10 copay for Tier 1 - Generic drugs after deductible.||$10 copay for Tier 1 - Generic drugs after deductible.|
|Lab tests||50.00% coinsurance after deductible.||50.00% coinsurance after deductible.|
|Hospital costs||50.00% coinsurance after deductible.||50.00% coinsurance after deductible.|
|Hospitals in network||Maimonides Medical CTR, NYU Langone Hospitals, St. Vincent’s Hospital.||Lenox Hill Hospital, Mount Sinai Hospital, Metropolitan Hospital.|
|Gym member reimbursement||Partial reimbursement for facility fees every 6 months if member attains at least 50 visits.||$200 per 6 months for subscriber. $100 per 6 months for spouse|
|Family planning||Free counseling on the use of contraceptives, sterilization procedures, and related topics included.||Free counseling on the use of contraceptives, sterilization procedures, and related topics included.|
The monthly premium refers to the amount you‚ll pay each month in order to remain covered under the insurance policy. It‚s important to note that these payments do not contribute toward the deductible on either of these bronze plans.
The monthly premium for the Empire BlueCross BlueShield bronze plan is $646.06. By contrast, the UnitedHealthcarebronze plan is over one hundred dollars more expensive and is $750.09 per month.
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A co-pay is simply a pre-determined amount that you will pay for receiving a specific service from a care provider, such as a visit to an urgent care facility.
For both the UnitedHealthcare and Empire BlueCross BlueShield bronze plan, the copay is expressed as a 50% coinsurance across the board after the deductible has been met. The only exception is prescription drugs, which is set at a $10 copay for generic drugs.
A deductible is a specified amount of money that you must pay before an insurance company will start to pay a proportion of your medical expenses. Being bronze health insurance plans, both of the deductibles are fairly high, with both UnitedHealthcare's and Empire BlueCross BlueShield's plans to come in at $5,500.
In an emergency situation, you should go to the emergency room or call 911 immediately if you are unable to make it there yourself. In an emergency, always focus on seeking medical attention first rather than on your insurance. For reference, an emergency is a situation whereby your life is in danger.
The bronze plans from each company offer insured parties 50% coinsurance once the $5,500 deductible has been met.
Urgent Care Coverage
Urgent care visits refer to instances whereby you may need medical attention, but you are not suffering from severe or life-threatening symptoms. For example, if you fractured your foot, you would most probably seek urgent rather than emergency care.
Both UnitedHealthcare and Empire BlueCross BlueShield will provide 50% coinsurance for such a visit after the deductible has been met for their bronze plans.
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Lab Test Coverage
You may require lab testing for a number of reasons. For example, the blood work from your annual physical will be sent for laboratory testing. In other cases, blood samples may be lab tested to detect specific illnesses.
Once again, both UnitedHealthcare and Empire BlueCross BlueShield will provide 50% coinsurance for these services after the deductible has been met.
What are people saying?
Empire BlueCross BlueShield has a rating of 1/5 stars based on 35 reviews on Consumeraffairs.com. Positive reviews include customer satisfaction with prompt handling of claims and minimal out-of-pocket expenses. Other customers were frustrated with their customer service experiences and confusing information regarding payment.
Empire BlueCross BlueShield Reviews customeraffairs.com
UnitedHealthcare has a rating of 4.5/5 stars based on 662 reviews on customeraffairs.com. Customers are pleased with the customer service and the knowledgeable patient coordinators. Others were frustrated with finding doctors that take this insurance plan and getting quick approval to see providers.
UnitedHealthcare Reviews customeraffairs.com
Which One Is Best?
Empire BlueCross BlueShield Bronze and UnitedHealthcare Bronze offer very similar benefits and payment options. UnitedHealthcare bronze has a monthly premium that is about $100 dollars more than Empire BlueCross BlueShield. However, UnitedHealthcare also has more positive reviews regarding customer service satisfaction.
It is important to note that these two plans have different hospitals in-network. While Empire BlueCross BlueShield covers Maimonides Medical Center, NYU Langone, and St. Vincent's Hospital, UnitedHealthcare covers Lenox Hill, Mount Sinai, and Metropolitan Hospital.
Overall, Empire BlueCross BlueShield is a great option, as you will save about $1,200 annually in monthly premiums and get very similar coverage.
The Mira Research team conducts original data and medical research on the most applicable topics of today and translates them into easy-to-understand articles to educate the public. Each of our articles is carefully reviewed and curated with interviews and opinions from medical experts, public health officials, and experienced administrators. The team has educational backgrounds from New York University, the University of Virginia, more.