About the Plans

What are Qualified Health Plans (QHPs)? 

QHPs are commercial health insurance plans offered by insurance companies to address the coverage needs of Minnesotans. All of the plans offer the same core set of benefits, including preventive services, mental health and substance abuse services, emergency services, prescription drugs and hospitalization. Some plans include benefits beyond the core set. 

Each of the plans has been reviewed by state regulators and approved to be sold on MNsure. 

All plans on the MNsure marketplace have been certified as QHPs.

Types of Coverage

Medical Plans

  • Most health plans are categorized and labeled as platinum, gold, silver or bronze metal level.
  • Each of the plans within a metal level generally offers the same amount of coverage with:
    • an associated premium amount (the cost of the insurance itself) 
    • out-of-pocket costs like deductibles (the amount you’re required to pay out-of-pocket for the year) copays (a fixed amount you pay for a type of medical service or prescription), or coinsurance (your share of the costs of a covered service, usually calculated as a percent).
  • Some plans may include dental benefits.  
  • Catastrophic plans are also available on MNsure.
    • These plans have a high deductible and offer less coverage than the metal level plans. Premium tax credits may not be used with these plans.  
    • Individuals must be under 30 or meet other criteria to be eligible to purchase a catastrophic plan.

Dental Plans

  • MNsure has plans which provide dental only coverage for children and families.

Coverage Levels

  • Bronze: the plan must cover 60% of expected costs for the average individual
  • Silver: the plan must cover 70% of expected costs for the average individual
  • Gold: the plan must cover 80% of expected costs for the average individual
  • Platinum: the plan must cover 90% of expected costs for the average individual

Plan Benefits

QHPs will cover:

  • A broad range of essential services, including doctor visits, hospital stays, maternity and newborn care, emergency room care, prescription drugs, preventive care, mental and behavioral health services and more.
  • Preventive services at no cost to you, such as blood pressure and diabetes screenings; cancer screenings such as mammograms and colonoscopies; vaccinations; flu shots and more.

All plans offered in the MNsure marketplace include new consumer protections.

  • No discrimination based on pre-existing conditions or gender
  • No annual dollar limit on coverage
  • No lifetime limit on coverage
  • A cap on out-of-pocket costs
  • Allows young adults to stay on their parent’s health insurance plan until age 26, unless they have access to coverage through their employer
  • Requires that 80-85 cents of every dollar you pay for health insurance is spent on delivering or improving health care – or you get a refund from your insurance company
  • Provides consumers a standard, plain language summary of your plan

Selecting a Plan

As you shop, you will see the following plan information:

  • The monthly premium amount
  • The tax credit amount for which you or your family may qualify
  • The deductible level
  • The metal level
  • If your plan includes dental coverage and who is covered: children only or the entire family
  • Whether a plan may be used with a Health Savings Account
  • Whether a plan offers a weight loss program or gym membership discount
  • Whether the plan is a preferred provider organization (PPO), a point of service plan (POS), or a health maintenance organization (HMO)
  • A summary of benefits and coverage for each plan that clearly explains general benefit and cost sharing information

To help you make your choice, we have developed an optional selection tool called “What Matters Most to Me.” The tool walks you through a list of targeted questions, pulls the plans that most closely match your personal preferences, and places them atop your list for a closer look. The tool is available in one of two ways: 1) after you create your account and begin your application; or 2). You can also use this tool after answering a few short questions.  Your responses will help pull up a list of plans you are able to purchase and accurate pricing information. 

Preview Provider Networks

Each QHP has a network of providers (doctors, clinics, hospitals) attached to it that have a signed contract with a health insurer to provide covered services to plan enrollees. Enrollees often receive the most coverage at the lowest cost when they use a provider in their network.

The prescription drugs covered (formulary) can vary from plan to plan.

Create an individual or family account

Get Help

Although the online application is straightforward, sometimes you want a little help understanding certain information or would like some advice. We have a network of partners in your community who can assist you. Find an assister through the Assister Directory

Or call the toll-free Contact Center line at 1-855-3MNSURE (1-855-366-7873) and talk with a specialist.