Open enrollment for 2021 is fast approaching, which makes now an excellent time to review health insurance plans. 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.
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 than their counterparts. Under government guidelines, 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 fit and healthy. They are a good fit if you want a low-cost way to protect yourself from worst-case medical scenarios and keep your monthly premiums low. 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.
Oscar Health Simple Bronze vs. UnitedHealthcare Compass Bronze
|Benefits||Oscar Bronze||UnitedHealthcare Bronze|
|Available on Exchange||Yes||Yes|
|No referral needed for specialist||✅||❌|
|Preventative care||$0 pre-deductible.||$0 pre-deductible.|
|Primary care||2 PCP office visits with $50 copayment not subject to deductible. Subsequent visits $0.00 copay after deductible||50.00% coinsurance after deductible.|
|Specialty visits||$0.00 copay after deductible||50.00% coinsurance after deductible.|
SOURCE: Mira Research
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 Oscar Health simple bronze plan is $542.43. By contrast, the UnitedHealthcare bronze plan is considerably more expensive and will set you back $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 the UnitedHealthcare bronze plan, the copay is expressed as a 50% coinsurance across the board post-deductible. The only exception is prescription drugs, which is set at $10 for generic drugs. However, the Oscar Health plan works differently, only offering copays on urgent care ($100) and two visits to a primary care facility ($50) pre-deductible. You will have to cover the full cost of any other medical services.
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. However, the Oscar Health bronze plan is considerably more expensive, coming in at $8,150, as opposed to UnitedHealthcare‚s $5,500.
Once you exceed the deductible, the UnitedHealthcare bronze plan begins to cost-share via a 50% coinsurance that will apply to almost all health care services you subsequently receive. By contrast, the Oscar Health bronze plan will pick up 100% of any subsequent costs once the deductible has been met.
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 rather than on your insurance. For reference, an emergency is a situation whereby your life is in danger.
For the Oscar Health bronze plan, you will pay 100% of the costs up to the deductible, after which point the plan picks up any remaining costs. On the other hand, UnitedHealthcare will offer 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 of life-threatening symptoms. For example, if you were suffering from kidney stones, you would most probably seek urgent rather than emergency care.
United Healthcare will provide 50% coinsurance for such a visit after the deductible has been met. Oscar Health offers a $100 copay for urgent care visits pre-deductible and picks up 100% of the costs thereafter.
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, United Healthcare will provide 50% coinsurance for these services after the deductible has been met. Oscar Health‚s bronze plan, however, will only pick up all of the costs once the deductible has been met. Until that point, you are responsible for 100% of the costs.
What are people saying?
Oscar Health has a 3-star rating on Google and an 8.4 overall score on Best Company.
UnitedHealthCare has a 3.7 rating on Consumer Affairs and a 2.7 rating on Wallet Hub.
Which One Is Best?
UnitedHealthcare Compass Bronze has a 38% higher monthly premium when compared to Oscar Bronze, however, when it comes to in-network hospital coverage, UnitedHealthcare has more prominent hospitals covered when compared to Oscar. UnitedHealthcare also offers gym reimbursement where Oscar does not. UnitedHealthcare also has a lower deductible when compared to Oscar.
Oscar, however, does not require a referral when visiting a specialist but UnitedHealthcare does require one.
Overall, UnitedHealthcare has more to offer, but at a higher price. Therefore, it depends on your needs and whether or not you prioritize no referral for specialist appointments as well as gym reimbursement.