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SOLO plans

2020 SOLO individual health insurance plans

SOLO plans include many benefits that help you (and your family) stay healthy -- and get the care you need if you get sick or hurt.  

Each plan name includes a ”metal level,” which tells you the average amount the plan pays for covered services. “POS” in plan names means you can visit out-of-network health care providers, but you will pay more. “HMO” plans limit you to visiting in-network doctors to have services covered. Plans with “HSA” in the name allow you to save money tax-free in a health savings account.

 

Metal levels

The chart below describes ranges of premiums and out-of-pocket costs for each plan level.

 

Metal level Premiums Out-of-pocket costs Plan pays*
Gold Plans Higher Lower 80%
Silver Plans Moderate Moderate 70%
Bronze Plans Lowest Highest 60%


*Average amount plan pays for covered services.
 

As you review our plans below, her are some important terms to know:

  • POS: Plans with POS ("point-of-service") in their name means you'll be able to visit out-of-network doctors, but you'll pay more
  • HMO: Plans with HMO ("health maintenance organization") in their name means you must visit in-network doctors to have those services covered.
  • HSA: This stands for "health savings account." HSA-compatible plans allow you to save money tax-free to use for qualified health care expenses.

*Integrated medical and prescription drug deductible.

Passage plan

With a Passage plan, you must choose a primary care provider (PCP) from those who accept the plan. You need your PCP to refer you to some types of specialists. Passage plans offer more value with no deductibles and low copays for primary and urgent care visits.

Passage SOLO POS Copay/Coins. $2,000 ded.

This gold plan waives the deductible for primary care provider (PCP) and specialist office visits. Members with this plan must use PCPs who participate in the Passage plan and must get their PCP’s referral to many types of specialists. PCP office visits have a $30 copay per visit.

Deductible: $2,000 individual / $4,000 family*

Passage SOLO HMO Copay/Coins. $6,250 ded.

This bronze plan waives the deductible for primary care provider (PCP) office visits. Members with this plan must use PCPs who participate in the Passage plan and must get their PCP’s referral to many types of specialists. PCP office visits have a $50 copay per visit.

Deductible: $6,250 individual / $12,500 family*

Choice plans

Choice plans let you visit any of the doctors, hospitals, labs, and facilities in our large statewide network and in parts of Massachusetts, Rhode Island, and New York. Some plans have low copays with no deductibles for primary care office visits, urgent care, and behavioral health.

Choice SOLO POS Coins. $3,000 ded.

This silver plan waives the deductible for primary care provider (PCP) office visits. PCP office visits have a $50 copay per visit. Members pay 50% coinsurance for specialist and mental health office visits and urgent care visits after they’ve met the in-network deductible.

Deductible: $3,000 individual / $6,000 family*

Choice SOLO POS HSA Copay/Coins. $3,500 ded.

After meeting the in-network deductible of this silver plan, members pay 25% coinsurance for in-network services, including primary, specialist, and urgent care, as well as hospitalization. 

Deductible: $3,500 individual / $7,000 family*

Choice SOLO POS Copay/Coins. $4,500 ded. 30%

This silver plan waives the deductible for in-network primary care provider (PCP) and specialist and mental office visits. Copays for in-network services include: $50 for PCP visits, $60 for specialist and mental health office visits, and $100 for urgent care. 

Deductible: $4,500 individual / $9,000 family*

Choice SOLO POS Copay/Coins. $4,500 ded. 40%

This silver plan waives the deductible for in-network primary care provider (PCP) and mental health clinician office visits. Copays do apply:  $40 for PCP and $50 for mental health office visits. Other services, like specialist office and urgent care visits, have copayments after the deductible is met.

Deductible: $4,500 individual / $9,000 family*

Choice SOLO POS Copay/Coins. $5,500 ded.

This silver plan waives the deductible for in-network primary care provider (PCP) and specialist office visits. Copays for in-network services include: $50 for other PCP office visits, $60 for specialist and mental health office visits, and $100 for urgent care visits. The deductible does not apply to these copays.

Deductible: $5,500 individual / $11,000 family*

Choice SOLO POS HSA Coins. $6,250 ded.

After meeting the in-network plan deductible, members with this bronze plan pay 25% coinsurance for in-network services, including primary and specialist care, urgent care, and hospitalization.

Deductible: $6,250 individual / $12,500 family*

Choice SOLO POS HMO HSA $6,500 ded.

After meeting the in-network plan deductible, members with this bronze plan pay copays or coinsurance for in-network services. 

 

Deductible: $6,500 individual / $13,000 family*

Massachusetts residents

See our plans or call your broker for plan options and information.

*Integrated medical and prescription drug deductible.

SOLO plans

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership 

Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.