Individual & Family plans

Mom and son playing with dogs outside.

You matter to us

You and your family's well-being is what’s most important to us at WellFirst Health — provided by SSM Health Plan. Let's face it, insurance can be confusing. So we want to make that part easy for you. 

WellFirst Health is a provider-owned health plan — a true collaboration between health care experts, hospital partners and insurance providers. That means we offer a better value and beneficial experience for members. With our coordinated approach, we focus on the doctor-patient relationship and not just insurance company profits. It’s insurance that members can feel great about.

Marketplace plans

View and compare Marketplace plan options.

See our Individual and Family plan book (PDF) for details about our 2021 plans or order a printed copy in the mail.

The Marketplace (also known as the Exchange or healthcare.gov) is where individuals can compare and purchase health insurance plans for themselves and their family. Marketplace plans are great for individuals and families who are eligible for discounts or financial subsidies. These discounts can include:

Tax credits - lower the monthly premium you pay for health insurance and are available for those who make about $51k or less for a single person. Advance payments of the premium tax credit are available to individuals with household income of at least 100% but not more than 400% of the Federal Poverty Level (FPL). You can use your tax credit on most Marketplace plans.

Cost sharing reductionsCouple sampling pasta sauce as they cook together in the kitchen.

  • Lower the amount you pay on health care services.
  • Cost sharing reduction plans are available for those who make about $31k or less for a single person.
  • Cost-sharing reduction is only available on silver plans.
  • There are three levels of cost sharing reduction based on income brackets:
    • 100–150 percent of FPL
    • 151–200 percent of FPL
    • 201–250 percent of FPL

2020 plan year Federal Poverty Level guidelines

 Percentage of Federal Poverty Level
Size of Household100%250%400%
1 Person$12,760$31,900$51,040
2 People$17,240$43,100$68,960
3 People$21,720$54,300$86,880
4 People$26,200$65,500$104,800
Coverage InformationMay qualify for
cost-sharing reductions
and advanced
premium tax credits
May qualify for
cost-sharing reductions
and advanced
premium tax credits
May qualify for advanced premium tax credits

 

WellFirst Health offers a variety of options for silver plans that are eligible for cost-sharing reduction plans.

Marketplace Calculator – do you qualify for financial help?

This calculator displays information for 2020 plans. Updated 2021 calculator coming soon!

Indy and family plan options

We have health insurance plans to fit your lifestyle and budget. Whether you’re looking for a lower-premium plan, to limit your overall out-of-pocket, or even just for a catastrophic safety net plan, we’re here for you.

You don’t like surprise bills? This may be the plan for you. These plans offer:
  • Low copays for office visits and many prescription drugs
  • Affordable deductible and coinsurance options
  • An easy way to build a relationship with a provider
View Marketplace options (PDF)
Keeping it simple for you. The Classic plan offers comprehensive coverage and simplicity, plus dependable copay options for prescriptions.

See Marketplace options (PDF)
If you prefer the lower premiums of a high-deductible plan along with low out-of-pocket costs for doctor visits, WellFirst has you covered. Our Value copay plan options are here to meet your needs.

Marketplace options (PDF)
Safety net plans or catastrophic plans are available for those who:
  • Are under the age 30
  • Meet income guidelines
  • Are comfortable with their health status
  • Our safety net plan offers a high deductible and three FREE office visits. Remember that government price breaks are not available with the safety net plan.
Open Marketplace options (PDF)
 
If you’re a saver you can take advantage of a health savings account (HSA) to cover your medical bills. We have excellent options. Combine a high-deductible health plan (HDHP) with an HSA for more financial freedom and flexibility.

See our Q&A
See our Marketplace options

 

Individual & Family Q&A

Learn more about health insurance basics and common questions & answers.