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Costs Explained

Health insurance covers some of your medical expenses if you are sick or injured. These services are generally referred to as non-preventive care. It also covers you when you are not sick and seeking care to prevent future health problems. These services are generally referred to as preventive care.

No Surprises Act

Starting in 2022, a new federal law, The No Surprises Act, will protect people from many types of "surprise" medical bills. Find more information at the following links:

Free Preventive Care

All health insurance plans sold through MNsure must cover a set of preventive care services at no cost to you—these services are free if you use a provider in your health plan's network. Preventive care includes annual checkups, screenings (such as blood pressure and diabetes screenings, mammograms and colonoscopies), vaccinations and flu shots. Read more about preventive care on 

How much you pay for non-preventive health care services varies by plan.

How Non-Preventive Costs are Shared

Key Factors

Below are the key components of cost sharing between you and your health insurance plan.

Cost Sharing Phases

For most health insurance plans, there are three basic phases of cost sharing for non-preventive care. The time it takes you to move through these phases depends on your health care needs. Depending on your needs you may not go through all three phases within a plan year.

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