Although it’s the time of year when your home’s decorations go from turkeys to Santas, on the healthcare calendar it’s open enrollment season. And that means it’s time, once again, for many people in the state to figure out how to get health insurance.
But do not worry. At The Colorado Sun, we’ve put together an extensive catalog of tips and resources you can use to find the health care coverage that’s right for you. Feel free to scroll through this guide to find the answers you’re looking for, or bookmark it for later.
Got a question we haven’t covered? Email me at johningold@coloradosun.comand I will try to help you find an answer.
Happy shopping and good luck.
What is the deadline for making a decision?
In the individual market, open registration lasts until January 15. But, if you want a plan with benefits that take effect on January 1, you must make a choice before December 15.
What is open registration?
Open enrollment is the time of year when you can switch health insurance plans. For most people, this only happens once a year.
If you are covered by an insurance plan through your job, your company sets the open membership period. (For government employees, for example, open enrollment is tied to the end of the fiscal year in June.) For people who buy insurance on their own, open enrollment always lands at the end of the year, as is the case for people looking for insurance. Medicare Advantage Plans.
Where can I ask questions about Medicare?
The State Health Insurance Assistance Program is a nationwide network of federally funded organizations that can help people with questions about accessing and using Medicare. In Colorado, there are SHIP programs in every county. You can find your county’s schedule, along with a phone number, in this list here.
The state Division of Insurance also provides Medicare links and guidance on its website..
I don’t know anything about health insurance, where do I start?
First, you need to know what market you are shopping in.
Are you covered by your employer’s health care plan? Seek information from Human Resources or your benefits provider about your options.
Do you do your shopping by yourself? Then you are in what is called the “individual market”. This means you will shop on Connect for Health Colorado or use a broker. Connect for Health is the state’s insurance exchange – think of it as an online shopping platform, Amazon for health insurance plans.
A few years ago we created a guide to buying a health insurance plan in Colorado. It applies primarily to people buying from the individual marketplace and contains tips for navigating Connect for Health. But it also offers advice from an actuary and a broker on how to assess the type of coverage you need, no matter what market you’re shopping in.
You can read this guide here.
If the language of the insurance world – deductible, co-pay, subsidy – is foreign to you, Connect for Health has a handy glossary that provides some definitions. (The glossary is also available in Spanish.)
Is there anything new this year?
If you are in the individual market, this is the first year you will be able to select a Colorado Option health plan.. Colorado Option plans are sold by every insurance company – so Kaiser Permanente has Colorado Option plans, Anthem has Colorado Option plans and so on. But these plans are built on a standard benefit design created by the state government.
The hope is that the Colorado option will make it easier for people to compare plans. You know what benefits you’re getting, so it’s all about choosing a plan at the right price and with the right network of doctors and other medical providers.
“There are more services that are covered at no upfront cost,” said Adam Fox, deputy director of the Colorado Consumer Health Initiative, which supported the creation of the Colorado Option. “So particularly routine primary care, behavioral health care, pre-pregnancy and post-pregnancy care, those services are covered with no additional copayment, no cost sharing.”
But there is a catch with Colorado Option plans. While they’re also supposed to be cheaper than typical plans, they’re more often than not the cheapest in terms of premium pricing. So they may not be the best or most affordable option depending on your particular needs.
I heard about OmniSalud, what is it?
OmniSalud is the other novelty of this year. This is a health insurance program designed specifically for people who cannot access insurance subsidies due to their immigration status.
Under OmniSalud, the state finances the subsidies. The money comes from a levy on health insurance premiumswhich in turn funds the Colorado Health Insurance Affordability Enterprisewho pays the grants.
OmniSalud plans are not sold on the regular Connect for Health Colorado insurance exchange. Instead, they’re sold on a new exchange called Colorado Connect., although the registration process starts on Connect for Health. The separation means that no information entered on Colorado Connect is shared with the federal government.
To access the Connect for Health Spanish site, click here.
What are the tips for choosing the right plan?
The Colorado Sun hosted a virtual roundtable on this topic with CCHI’s Fox, Connect for Health CEO Kevin Patterson, and state Insurance Commissioner Michael Conway.
If you want to see the whole thing, you can find the video on this link.
But here are some quick tips:
Fox recommended not just buying the plan with the lowest premium. These plans often have high deductibles, and if you have more than minimal health care needs, buying the cheapest plan could mean paying more in the long run.
“What you’re really talking about when comparing health insurance options is comparing your current medical needs versus what you might anticipate in the coming year, and your comfort with financial risk,” said said Fox during the panel. “We’re really trying to encourage consumers to think, yes, there might be a bit more premium (price) for buying a silver level plan or a gold level plan. But those really offer better protection for people’s finances.If something big happens to you, it’s really easy to rack up thousands of dollars in medical bills very quickly.
Conway encouraged people to check Connect for Health to see if they qualify for federal grants that help pay for the cost of premiums. The US Federal Bailout Act extended these grants to people who earn more money and the Inflation Reduction Act extended these expanded grants.
“If you haven’t purchased Connect for Health Colorado in the past two years, it’s critical that you continue now due to the increased grants that were originally part of the US bailout,” a- he declared.
Patterson said people shouldn’t hesitate to ask for help when they get stuck.
“It’s a daunting task if you’re not sure what you’re looking for,” Patterson said. “And so we always encourage people to search for a broker, to search for an assistant.”
How do I know when to buy from Connect for Health rather than using an assistant?
Assistants are people who can help you enroll through Connect for Health. Brokers can also do this, but they can also help you buy an off-exchange plan if that’s the best option.
Both are generally free for consumers, but be sure to ask a broker about potential fees.
Connect for Health offers research tools for both brokers and helpers on its website under the menu header on the far right of the page that says “We can help you”.
If you qualify for premium grants, Connect for Health is the only place you can get them. Brokers, on the other hand, act as agents to find people the best deal based on their needs, whether that plan is in exchange or not.
“Our job is always to advocate for our clients,” said Meagan Fearing, president of the Colorado State Association of Health Underwriters, which is a trade group for brokers. “For those who don’t use a broker, for heaven’s sake find a broker and make sure you make an educated and educated selection.”
The National Association of Health Underwriters also maintains a search tool to find member brokers.. Just be sure to book an appointment quickly. Like accountants at tax time, brokers are booked up fairly quickly during open registration.
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