Ready to enroll in a health plan?

Ask 9 questions first

To choose the right health insurance plan for you and your family understand the available choices and determine how they best meet your needs

Review your coverage options

When choosing a health insurance plan, consider the level of coverage you require Individual or family plans are classified by coverage levels, such as platinum, gold, silver and bronze

Additionally, some individuals may qualify for catastrophic plans on the Health Insurance Marketplace It s important to note that these categories do not affect the quality of care provided but rather how costs are divided between you and your plan. What do health plan coverage levels mean?

What’s the difference between a bronze, silver, gold, platinum, or catastrophic health plan?

These categories or “metal levels ” show how costs are split between you and your insurance plan. However, it’s important to note that the classification does not necessarily reflect the quality of care Some individuals may also have access to “catastrophic” plans, which are open to people under 30 or with a hardship exemption.

You can apply financial help to any metal tier plan except for catastrophic plans

Check premiums, copayments, and deductibles All insurance plans include multiple out-of-pocket expenses, including:

• Premium: A set monthly cost for coverage, regardless of services used.

• Copay: Additional fixed-fee payments charged for care such as office visits and prescriptions

• Deductible: Fees you must pay before your insurance coverage begins

• Coinsurance: Most plans cover a percentage of costs (for example 80%), while you are responsible for paying the rest.

Assess your potential needs and compare the associated plan costs over the next year

Check provider networks

List healthcare providers you and your family use or might need in the coming year That can include physicians specialists, hospitals, clinics, and pharmacies When evaluating plans during open enrollment, check if they cover your preferred providers

Understand contracts between medical professionals and insurance companies are subject to change Providers your plan covered last year may not be included in the future

Make sure your plan covers your medications

Compile a list of your medications and know whether they are brand name or generic. As brand-name drugs can be expensive, securing a policy that covers them is essential. Generic medicines are cheaper so if your prescriptions mainly consist of generics, you may have more options or be comfortable paying them out of pocket. Call the insurance company to confirm coverage for your medications and inquire about copay fees for filling and refilling prescriptions

Consider enrolling in HSAs and FSAs Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) set aside pre-tax money to pay for qualified healthcare costs, including copays medications and medical devices

Not everyone can participate in these programs HSAs necessitate enrollment in an HDHP or catastrophic plan, while FSAs are exclusively accessible through employers (and may not be an option at all workplaces).

• Anthem

Cigna

• Denver Health Kaiser

• Rocky Mountain Health Plans

• SelectHealth

What health insurance resources are available to Colorado residents?

Connect for Health Colorado: This is the state’s marketplace/exchange

Residents can use Connect for Health

Colorado to enroll in individual/family health plans, receive income-based subsidies and enroll in Health First Colorado You can contact Connect for Health Colorado at 855-752-6749

Colorado Division of Insurance: Regulates the insurance industry in Colorado and assists consumers and businesses with insurance-related questions and concerns

Colorado Department of Health Policy and Financing (HCPF): Administers Medicaid (Health First Colorado), Child Health Plan Plus (CHP+), and other health care programs

Colorado Senior Health Care and Medicare Assistance: A service for Colorado Medicare beneficiaries and their caregivers, providing information and assistance with questions related to Medicare eligibility, enrollment, and claims

Verify the contribution restrictions and rollover regulations before enrolling in an HSA or FSA Also, determine your expected medical expenses for the coming year

Understand the difference between HMOs and PPOs Health Maintenance Organizations (HMOs) limit coverage to innetwork doctors Preferred Provider Organizations (PPOs) offer partial coverage for out-of-network services

HMO networks are typically smaller and require your primary care physician to refer you to a specialist. HMO plans generally have lower premiums and deductibles PPOs usually have larger networks and do not require referrals, but they tend to be pricier

When is the open enrollment period?

Colorado’s open enrollment period runs from Nov 1 through Jan. 15 For coverage to start on Jan. 1, you must complete your application by Dec. 15 Coverage begins Feb 1 for applications submitted from Dec. 16 to Jan. 15 out-of-pocket expenses than traditional Medicare Additionally, these plans may provide additional benefits such as vision, hearing, and dental services that original Medicare does not cover

If you qualify, you can enroll yearround in Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+).

What is a special enrollment period?

If you experience a major life event, like pregnancy, losing health coverage from a job or moving to a new area, you may qualify for a Special Enrollment Period. This allows you and your family to shop for and enroll in a new health insurance plan.

While non-emergency coverage may be available out of network with some plans it usually comes at a higher expense And seeing a specialist may require a referral.

According to experts, evaluating your current plan and its suitability is crucial before considering a switch.

Review three critical factors: continue to be covered by your plan and the expected costs using the government s Medicare plan finder tool. and Part D coverage It often requires using in-network doctors and may have lower

2 Doctors: If you have a Medicare Advantage plan, you must ensure your doctors remain within the network. If you have traditional Medicare all doctors who accept Medicare are automatically covered.

1. Medications: Catalog names dosages and brand name or generic status of prescribed drugs Confirm the drugs will

3 Costs: Compare premiums and out-ofpocket maximums between plans Consider all expenses, especially for Medicare Advantage plans advertising $0 or low premiums Also, remember everyone must pay the monthly Medicare Part B premium. People with higher incomes may pay additional costs for Part B