Navigating insurance
Three Bronze plans. Same carrier. Not even close.
Why plans with the same label can cost $500 or $8,250 for the same ER visit.
Three Bronze plans. Same carrier. Premiums within $120 of each other.
They should be basically the same product. Let’s see what happens when the same person has the same medical event on each one.
Three plans labelled Bronze from the same carrier, listed with nothing but their monthly premiums: Plan A at $321, Plan B at $327, and Plan C at $440.
All labelled Bronze · same carrier
- Plan A
- $321/mo
- Plan B
- $327/mo
- Plan C
- $440/mo
On the shelf, that is everything you are shown.
Plan A: the catastrophe bet. $321/month, $8,250 deductible.
Nothing is covered until you’ve spent $8,250. This is disaster insurance with a tax shelter. If you’re healthy and have cash reserves, this plan costs the least — until something happens.
Plan A broken out: a $321 monthly premium, an $8,250 deductible, and full price for both primary care visits and prescriptions until that deductible is met.
Plan A — the catastrophe bet
- Premium
- $321/mo
- Deductible
- $8,250
- PCP visits
- Full price
- Prescriptions
- Full price
Plan B: the hedge. $327/month, $5,000 deductible.
Three free PCP visits and $10 generic drugs before the deductible. But a specialist visit? You pay full price until $5,000, then 40% after that.
Plan B broken out: a $327 monthly premium, a $5,000 deductible, three free primary care visits and then 40% coinsurance, and $10 generic drugs.
Plan B — the hedge
- Premium
- $327/mo
- Deductible
- $5,000
- PCP visits
- 3 free, then 40%
- Prescriptions
- $10 generics
Plan C: the chronic manager. $440/month, $0 medical deductible.
$30 doctor visits and $75 labs from day one — what’s called first-dollar coverage. But hidden in the details: a $2,900 drug deductible. Your medication costs $300/month out of pocket until you hit it.
Plan C broken out: a $440 monthly premium, a $0 medical deductible, $30 copays for primary care, and a separate $2,900 drug deductible sitting behind the prescriptions line.
Plan C — the chronic manager
- Premium
- $440/mo
- Medical deductible
- $0
- PCP visits
- $30 copay
- Prescriptions
- $2,900 drug deductible
Same February ER visit. Three very different bills.
Bronze doesn’t mean bronze. These plans are built for completely different kinds of years.
The same February emergency room visit billed against each plan: Plan A leaves $8,250 to pay, Plan B leaves $3,200, and Plan C leaves $500.
February ER visit — same injury, three bills
the catastrophe bet — the whole deductible, in one night
the hedge
the chronic manager
The same injury. The same carrier. Three bills ranging from $500 to $8,250. “Bronze” is a label, not a product.