Open enrollment is an important time to compare and contrast health insurance plans so you can have health coverage for the following year. Each plan has its own values and offering so picking the best option for you is essential. There are different tiers of health insurance. In this comparison of Healthfirst and MetroPlusHealth, we are analyzing the bronze plan.
What Does a Bronze Plan Offer?
As part of the metal tiers, bronze health plans have lower costs compared to the other medal categories, and the insurance company typically covers about 60 percent of the costs.
This plan category describes individual health insurance plans with the least expensive premiums and the highest copays and coinsurance amounts.
Is a bronze plan the right fit for me?
A bronze plan may be a good fit for you if prefer:
- Lowest option for monthly premium (which you will pay every month, whether or not you use the insurance)
- Highest costs when you are in need of care
- Bronze plan deductibles high deductibles, the amount you will pay before insurance pays
- A low-cost way to protect yourself from worst-case medical scenarios, such as serious sickness or injury. Your monthly premium will still be low, however, most other payments will still be billed to you.
Here's A Comprehensive Breakdown Comparing Healthfirst's Bronze Plan and MetroPlusHealth's Bronze B-2 HSA Plan:
|Healthfirst Gold||MVP Health Care Gold|
|Available on Exchange||Yes||Yes|
|No referral needed for specialist||✅||✅|
|Preventative care||$0 pre-deductible||$0 pre-deductible|
|Primary care||$25 co-pay post deductible||$25 co-pay post deductible|
|Specialty visits||$40 co-pay post deductible||$40 co-pay post deductible|
|Urgent care||$60 co-pay post deductible||$60 co-pay post deductible|
|Prescription drug deductible||$10 co-pay/30-day prescription (retail) and $25 co-pay/90-day prescription (mail order) for Tier-one generic drugs||$10 co-pay/30-day retail (deductible waived) and $25 co-pay/90-day mail order (deductible waived) for Tier-one generic drugs|
|Lab tests||$40.00 Copay after deductible||PCP: $25 copay*/Spec: $40 copay*|
|Healthfirst Gold||MVP Health Care Gold|
|Hospital Cost||$1000.00 Copay per Stay after deductible||$1,000 copay/continuous confinement deductible applies|
|Hospitals in network||New York-Presbyterian/Lower Manhattan Hospital, Mount Sinai Beth Israel, Mount Sinai Beth Israel, Interfaith Medical Center, Wyckoff Heights Medical Center, University Hospital of Brooklyn, Mount Sinai Hospital, Staten Island University Hosp-North, and more||Montefiore Mount Vernon hospital, SJRH - Park Care Pavilion, New York-Presbyterian Lawrence Hospital, SJRH - St. Johns Division, SJRH - Dobbs ferry Pavillion, Blythedale Children's Hospital, White Plains Hospital Center|
|Gym member reimbursement||✅Up to $400 during coverage year; up to an additional $200 during coverage year for Spouse||✅ Up to $600 in rewards and reimbursements with WellBeing Rewards per contract per calendar year|
|❌ No in network cost share||❌ No in network cost share|
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A monthly premium is an amount you‚d be paying out of pocket monthly for the insurance plan. MetroPlusHealth‚s bronze plan has a slightly higher monthly premium at $477.42 per month while Healthfirst has a monthly premium of $466.16.
The co-pay is a fixed amount you pay for a service or prescription, typically paid before the service. For prescriptions, both Healthfirst and MetroPlusHealth have similar copay policies. For prescription, both insurance options have a $10.00 copay post deductible.
A deductible is an amount paid out of pocket by the patient before an insurance provider will pay any expenses. Expenses are affected due to when they must be paid, either pre-deductible or post- deductible. For primary care, Healthfirst covers three visits before 50% coinsurance is applied post deductible. MetroPlusHealth applied 50% coinsurance post deductible for each primary care visit.
Virtual care for only $5 per visit
Virtual primary care or urgent care visits are only $5. Behavioral health visits are $15.
Hospital coverage is what the insurance would cover if you have to use a hospital whether or not it's planned. There's a 50% Coinsurance after deductible for both Healthfirst as well as MetroPlusHealth.
Urgent Care Coverage
Urgent care coverage includes the amount the insurance would pay for an urgent care visit. MetroHealthPlus and Healthfirst both have a 50% coinsurance post deductible.
Lab Test Coverage
If you are ordered lab tests from a physician or other healthcare professional, lab test coverage is the amount in which the insurance would cover that. MetroPlusHealth does cover lab test coverage at a 50% Coinsurance after deductible. Healthfirst also has 50% Coinsurance after deductible.
Which plan is best for me?
Healthfirst Leaf Plans offer complete coverage, and includes telemedicine (24/7 communication with a participating provider), as well as preventive and annual check-ups, prescription drugs, and more. The Bronze plan includes access to a large network of thousands of providers. No referrals required for specialists, obstetric and gynecologic services, chiropractic services, outpatient mental health, and substance abuse services, pediatric dental care, pediatric vision care (except an ophthalmologist).
MetroPlusHealth offers coverage with no cost-sharing for most preventive services (annual physicals, well visits, select contraception). Non-Standard plans include adult dental and vision coverage. HSA plans are also available for members seeking to maximize their care with a Health Savings Account.
While Healthfirst and MetroPlusHealth have many similarities in their bronze plans, MetroPlusHealth is the better option, especially if you're looking to save more money on a monthly premium and deductible.