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Summary of Benefits and Coverage

The summary of benefits (SBC) is a document provided by your insurance company that explains in plain language the benefits of your plan and what your plan covers. The SBC summarizes key features of your plan and uses an easy-to-understand question-and-answer format. SBCs are also available to consumers as they shop and compare plans on MNsure: look for the View/Print SBC link on the plan comparison screen.

Some of the information you will see on your SBC:

  • The overall deductible
  • Deductibles for specific services
  • Out-of-pocket limit on your expenses
  • What is not included in the out-of-pocket limit
  • Overall annual limit on what the plan pays
  • Is there a network of providers for the plan
  • Is a referral needed to see a specialist
  • Services the plan does not cover
  • Your cost if you use a provider in your network
  • Your cost if you use provider out of your network
  • How prescription medications are covered
  • Definition of words used on the SBC
  • Numbers to call if you have questions

Example summary of benefits document (PDF)

If you have questions about the information on your SBC, contact your insurance company.

Your summary of benefits and coverage gives a good overview about your plan, but it will not contain all the details and rules about your plan. You'll find that information on an evidence of coverage document for your plan.

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