Individual & family plans

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, health coverage can be confusing. So we want to make that part easy for you.

Marketplace plans

View and compare

For costs and further details of the coverage, view Summary of Benefits & Coverage

The Marketplace (also known as the Exchange or is where individuals can compare and purchase health 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 - Tax credits lower the monthly premium you pay for health coverage and are more available than ever due to the 2021 American Rescue Plan act. Depending on your household income level, these credits can pay for a considerable amount of your premium. 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 $31,000 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% of FPL
    • 151–200% of FPL
    • 201–250% of FPL

2023 plan year Federal Poverty Level guidelines

 Percentage of Federal Poverty Level
Size of Household100%250%400%
1 Person$14,580$36,450$58,320
2 People$19,720$49,300$78,880
3 People$24,860$62,150$99,440
4 People$30,000$75,000$120,000
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


We offer a variety of options for silver plans that are eligible for cost-sharing reduction plans.

Marketplace calculator – do you qualify for financial help?

Plan options

We have health 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
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You keep yourself healthy with regular visits to your PCP. Our Copay PCP plans keep your premiums low, and offer you the best value for your regular PCP visits and generic prescription drugs.
  • Affordable primary care and generic drug copays to cover your health concerns and maintenance
  • Affordable deductible and coinsurance options
  • An easy way to maintain or build your relationship with your provider
  • Lower monthly premium savings 
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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

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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 tax credits and cost share reductions are not available with the safety net plan.
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Simplify your shopping experience with standard plans. Standard plans make it easy to shop across all of the important services you need. Our standard plans are offered at every network type, metal tier, and in every service area that we offer coverage.

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Learn more about our plans

Our plans not only offer the 10 essential health benefits, but $0 preventive services and additional benefits to put your health and wellness first: 

Metal tiers

All Individual & family plans are divided into metal categories. These categories show how you and your plan share costs. No matter which category your plan falls in, the quality of care does not change.

Individual & Family Q&A

Learn about health coverage basics

Special enrollment information 

Outside open enrollment, you can enroll in new coverage or make changes to your existing policy—if you have a certain life event that qualifies you for a special enrollment period. 

See special enrollment details

Individual & Family plan service area map

Map of the six counties in our individual and family plan service area