Open enrollment ends Jan. 15: 6 things to know about health insurance |

Open enrollment ends Jan. 15: 6 things to know about health insurance

Craig Press staff report

Colorado’s official health insurance marketplace — Connect for Health Colorado — reminds consumers that open enrollment ends on Jan. 15.

“We are the only place to apply for financial help to reduce your monthly health insurance costs,” according to the marketplace website.

Following are six things to consider when seeking health insurance coverage in 2019.

• Insurance helps keep people healthy: All plans cover many preventive care services, even for those who have not met deductibles, including wellness visits, vaccinations, screenings for mental health, cancer, heart disease, cholesterol and diabetes, and more — at no additional cost.

• Insurance protects from debt: No one plans to get sick or hurt, but most people need medical care at some point. It’s hard to predict when and what type of care will be needed, let alone how much it will cost. Fortunately, health insurance is designed to greatly reduce the burden of the costs of care. The average cost of a three-day hospital stay without health insurance is $30,000, and treating a broken leg can cost up to $7,500. Having health insurance can provide protection from high, unexpected costs such as these.

• Insurance helps pay for care: Health insurance is designed to share costs with the patient. Patients may have to pay coinsurance or a copay as their share of the cost when receiving medical service, such as a doctor’s visit, hospital outpatient visit, or prescription. Patients may have to pay a deductible each plan year before the insurance company begins paying for care. For example, if a person who carries a $2,500 deductible goes to the emergency room, and the total cost is $3,500, the person would pay the first $2,500 to cover the deductible. Once a person has spent the out-of-pocket maximum, his or her insurance will pay 100-percent of covered health care costs.

• There are many kinds of plans: While all health insurance plans are required by federal law to include the essential health benefits, individual health insurance plan options vary significantly in the type of plan, size of the provider network, how they share costs with the patient, and the benefits they provide (outside those required by law). Plans can easily be compared using an online Quick Cost & Plan Finder tool. Take time to read the Summary of Benefits and Coverage for each plan under consideration.

• Staying in the plan network saves money: Health insurance plans contract with networks of hospitals, doctors, pharmacies, and health care providers to take care of people in the plan. Most plans will only pay when patients receive care from a provider in the plan’s network. Those who go out-of-network will likely have to pay the full bill.

• Be aware of insurance-like products: Outside of the Connect for Health Colorado Marketplace, consumers may see products that look and sound like health insurance but don’t offer the same protection as full health insurance. Some examples are policies that only cover certain diseases, policies that only cover accidents, or plans that offer discounts on health services. There are also short-term plans that only last for six months. All plans sold through Connect for Health Colorado offer all of the benefits and protections of a qualified health plan, including coverage for pre-existing conditions, which is protected under Colorado law.

Source: Connect for Health Colorado