Colorado officials stress there’s still time to buy health insurance
Experts advise residents to seek out help as they purchase plans
January 11, 2016
Craig — Officials at the Northwest Colorado Visiting Nurse Association stress that it's not too late for residents to sign up for insurance under the Affordable Care Act, even as deadlines loom. But they also stress the importance of seeking help.
"A lot of people have never had health insurance before, so they need guidance," said Jenny Earls, eligibility coordinator for the Northwest Colorado VNA. "A broker can give them advice and break down plans."
To be covered by Feb. 1, individuals must purchase health insurance by Jan. 15. The signup deadline for coverage starting on March 1 is Jan. 31 — and that's the last chance to sign up for this year, although exceptions exist for life-changing events.
More than 169,000 state residents have enrolled in health coverage between Nov. 1 and Dec. 31, 2015, according to data released by Connect for Health Colorado and the Colorado Department of Health Care Policy and Financing. Those enrollments occurred in private health insurance purchased through the state health insurance marketplace, in Medicaid or Child Health Plan Plus.
Residents qualify for health insurance subsidies based their annual income. And in Colorado, the expansion of Medicaid covers residents who make up to 138 percent of the federal poverty level.
Some people, though, may not know what their incomes for the coming year will be, creating a tough decision when it comes to choosing a health insurance plan. People in that situation should seek out help, said Janie Dunckley, director of business development for the Northwest Colorado VNA.
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"If you're a freelancer or anything like that, then you need to come and talk to someone," she said. "No one case is the same."
Greg Neal agreed. Neal, of Craig, is a broker with Western Slope Health Insurance LLC, and he's also a certified broker with Connect for Health Colorado.
Connect for Health Colorado serves as the online marketplace for the Affordable Care Act in the state.
"If you're self-employed, the best things to look at are (your) last two tax forms and get an estimate," he said. "Take your average and put it down."
Neal also said a person should make adjustments later in the year if income expectations change. He stressed that the subsidies people receive are "advanced premium tax credits," credits based what a person will likely earn. If the income is lower than expected, the subsidies may be higher — and vice versa.
After the year is complete, the subsidies then become finalized.
Dunckley said there have been significant health gains among people who have become insured in the last couple of years, but she also noted that health costs can remain high even for someone with insurance.
"We've seen trends of people gaining coverage over the past two years, and now they're able to treat things that had gone untreated for a long period of time," she said. "We're also finding that although more people have health insurance, there could be access issues to specialty or dental (care). You have coverage, but you might not have a place to go."
Luke Clarke, director of communications for Connect for Health Colorado, said the network of providers for any given health care plan tends to be narrower than it was some years ago.
"That phenomenon predates us," Clarke said, referring to Connect for Health Colorado, now operating in its third year as the state's marketplace for health insurance under the Affordable Care Act.
Clarke said the Connect for Health Colorado website harbors tools to help people shop around for the best plan, such as a program that allows a person to plug in a medication and find out how that medication is treated by various plans. But Clarke, too, stressed the importance of seeking help when signing up.
"Most of us walk around without a great deal of knowledge about health insurance, and even less about health care, and then we go and spend a lot of money on them," he said.
Both Dunckley and Neal emphasized that penalties for people without health insurance will be steeper in the coming year than in the past. For a single adult, the fine for 2016 will be $695 or 2.5 percent of the income, according to healthcare.gov. Families pay an additional $347.50 per child, with a maximum penalty of $2,085.
The penalty is prorated by the month and kicks in once a person misses more than three months of coverage.
Farrah Smilanich, community health and outreach manager for the Northwest Colorado VNA, emphasized that it's not too late to sign up for insurance, even if a person still feels unsure of the process.
"Contact a broker, contact us," she said. "Someone can help you walk through this. It is not too late."
People seeking assistance in enrolling in health insurance can contact a Health Coverage Guide at the Northwest Colorado Visiting Nurse Association at 970-871-7324. Drop-in open enrollment assistance also is available 5:30 to 7 p.m. Jan. 14 at YampaCare Family Medicine, 595 Russell St. in Craig.