Colorado has had its share of health insurance issues in recent years, but continue reading to find out what the best health plans in Colorado are available for you personal situation.
The Rocky Mountain state insurance market is still reeling from the departure of Bright Health, Oscar Health from the state, and most recently the spectacular collapse of Friday Health this summer, which left thousands scrambling to find new coverage.
Best Health Plans in Colorado
Colorado consumers are also facing the second highest average health insurance premiums in the country, second only to Georgia.
Meanwhile, the state’s efforts to introduce a public option have largely fizzled, with Colorado Option plans failing to gain much foothold among consumers or providers.
So there aren’t as many health insurance options as there used to be. And if you’re among those Coloradans who don’t receive a subsidy, those options are typically more expensive than they were last year.
Nevertheless, there are still several solid options for Colorado families looking for a health plan.
These include both traditional health insurance carriers like Anthem Blue Cross, and Cigna, as well as some of America’s top health sharing plans, which offer an affordable non-insurance alternative to Colorado residents.
In fact, as Colorado health insurance premiums continue to escalate for non-subsidized households, thousands of Rocky Mountain State residents are turning to health sharing plans as an alternative.
This article will discuss the options available to Colorado families, the pros and cons of each, and who might be a good candidate for each plan.
There’s no single best solution that meets every household’s needs. The best solution for you depends on your budget, family, medical needs and history, as well as the amount of available subsidies you may qualify for under the Affordable Care Act.
Open Enrollment in Colorado
If you want to enroll in a new or different health insurance plan in Colorado for 2024, it’s important to act in a timely fashion.
Open enrollment season starts on November 1st and runs through January 15th. If you want your new plan to be effective on January 1st, you must complete your enrollment by December 15th.
If you miss your open enrollment period, you may not be able to enroll in a new health insurance plan and have it become effective until 2025, unless you have a qualifying life event such as marriage, divorce, the birth or adoption of a new child, etc.
So to preserve your options, it’s a good idea to make your decision during Open Enrollment, while you still have all your options available to you.
Health Plans in Colorado: Bronze, Silver, Gold & Platinum
- Coverage Level: Platinum plans offer the highest level of coverage.
- Costs: They have the highest monthly premiums, but you’ll pay less when you see the doctor or get medical care. Great for those who go to the doctor often.
- Coverage Level: Gold plans offer a high level of coverage.
- Costs: They have moderate monthly premiums and reasonable costs when you get medical care. Good for those who want decent coverage without very high premiums.
- Coverage Level: Silver plans provide moderate coverage.
- Costs: They have moderate monthly premiums and fair costs when you receive medical care. Common choice for those who need balanced coverage.
- Coverage Level: Bronze plans offer the lowest level of coverage.
- Costs: They have the lowest monthly premiums but higher costs when you get medical care. Suitable for generally healthy people who don’t visit the doctor often.
- Coverage level. These are effectively extremely high-deductible plans that only provide coverage for very significant and costly medical events. The deductible is typically the same as the out-of-pocket maximum for the year. You must pay out of pocket for everything else.
- Cost. These plans have lower premiums than even “Bronze” tier plans. However, they don’t qualify for subsidies under the Affordable Care Act. You must pay the entire premium out-of-pocket.
- Restrictions. These plans are only sold to those age 30 and under, or who meet specific hardship criteria. Because children tend to visit doctors’ offices more and tend to need more medical care, catastrophic plans may not be a great fit for families with small children, unless you have substantial cash reserves and can easily pay your deductible.
Health Insurance Tips
Don’t shop on monthly premiums alone. You should also consider deductibles, co-pays, co-insurance, and maximum out-of-pocket costs as well.
Check the plan’s provider network. Look at the plan’s network of authorized care providers. Are the doctors, hospitals, and other providers you want to use available to you?
Is your favorite pediatrician in the plan? Or will you need to change pediatricians? Will you need to pay extra to use them?
How far will you need to drive to see your doctor or your children’s doctor?
Check the plan’s drug formulary. This is the plan’s list of covered drugs. Are all the drugs you and your family members rely on included in the formulary? At what tier level? What will be the deductible and/or copay when you refill your prescription?
COLORADO HEALTH INSURANCE
Top Health Insurance Plans in Colorado
While there aren’t as many health insurance providers doing business in the individual market in Colorado as there were a couple of years ago, there are still several quality options.
Let’s explore some of the prominent health insurance providers in Colorado, along with their respective advantages and disadvantages:
- Extensive Network: Anthem Blue Cross Blue Shield boasts a broad network of healthcare providers, ensuring you have access to diverse medical professionals.
- Comprehensive Coverage: Their plans often include preventive care, prescription drug coverage, and maternity care benefits.
- ACA Compliance: Anthem Blue Cross Blue Shield offers ACA-compliant plans, allowing you to benefit from essential health benefits.
- Cost: Premiums for Anthem Blue Cross Blue Shield plans can be relatively higher compared to some other options.
- Complexity: The multitude of plan choices can be overwhelming, requiring careful consideration.
- Customization: Cigna is known for its flexible and customizable plans, allowing you to tailor coverage to your family’s needs.
- Wellness Programs: They often include wellness programs and tools to help you manage your family’s health effectively.
- Access: Cigna provides access to a network of healthcare professionals for comprehensive care.
- Cost Variation: The pricing of Cigna plans can vary based on factors like location, plan type, and family size.
- Network Limitations: Some Cigna plans may have network restrictions, which could impact your choice of healthcare providers.
- Local Presence: Denver Health Medical Plan is a local option with a strong presence in the Denver area, ensuring access to quality care.
- Coverage Options: They offer a range of family plans with options for preventive care, maternity care, and pediatric services.
- Community Commitment: Denver Health Medical Plan is committed to serving the local community.
- Limited Coverage Area: Coverage may be primarily centered around the Denver region, potentially limiting options for those outside the area.
- Plan Availability: Plan availability may vary by location, affecting your choices.
UnitedHealthCare is a prominent player in the health insurance landscape, offering a range of family health insurance plans in Colorado. Let’s explore the advantages and disadvantages associated with UnitedHealthCare:
Advantages of UnitedHealthCare:
- Network Access: UnitedHealthCare boasts an extensive network of healthcare providers, ensuring you have access to a wide array of doctors, specialists, and healthcare facilities.
- Comprehensive Coverage: Their family plans often include essential benefits such as preventive care, prescription drug coverage, and maternity care benefits.
- Innovation: UnitedHealthCare is known for its innovative approaches to healthcare, often providing tools and resources to help you manage your family’s health effectively.
Disadvantages of UnitedHealthCare:
- Cost Variation: As with many insurance providers, pricing for UnitedHealthCare plans can vary based on factors such as the plan type, location, and family size.
- Plan Complexity: The multitude of plan options and coverage choices can be complex, requiring careful consideration.
Choosing the Right Health Plan in Colorado for Your Family
Two common types of health plans offered nationwide under the Affordable Care Act are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). However, there are no PPOs being marketed in Colorado. Only HMOs.
Here are some of the advantages and disadvantages of HMOs.
HMOs (Health Maintenance Organizations):
- Lower Costs: HMOs often have lower premiums and out-of-pocket expenses.
- Primary Care Physician (PCP): HMOs typically require a PCP referral for specialist visits, ensuring coordinated care.
- Preventive Care: HMOs often emphasize preventive care and wellness programs.
- Limited Choice: HMOs have restricted networks, limiting your choice of healthcare providers.
- Referral Requirement: Requiring a referral for specialists can lead to delays in accessing specialized care.
- Out-of-Network Costs: Out-of-network care may not be covered, except in emergencies.
Health Sharing Plans: An Affordable Alternative
For people who don’t get a significant subsidy under the Affordable Care Act, non-insurance-based health sharing plans are a compelling and money-saving alternative.
On average, health sharing plans sell for around half the monthly cost of an unsubsidized traditional health insurance policy with comparable benefits.
In addition to traditional health insurance options, consider the advantages and disadvantages of health sharing plans when seeking to reduce healthcare costs for your family:
Advantages of Health Sharing:
- Cost Savings: Health sharing plans often offer potential savings on monthly healthcare expenses.
- No limited care networks. Health sharing plans typically allow much more freedom for you to choose your own doctors and other healthcare providers compared to the HMOs and PPOs that dominate the health insurance market.
- Community Support: Members share medical expenses, fostering a sense of community and support.
- Faith-Based Options: Some health sharing plans align with specific faith-based values and lifestyles.
- No limited open enrollment periods. You can enroll any time during the year.
Disadvantages of Health Sharing:
- Waiting Periods on Pre-Existing Conditions: Healthshare plans typically don’t share expenses for treating pre-existing conditions until a period of time has passed. They also don’t share certain surgery costs for new members for a period of time. If you or a member of your household has pre-existing conditions that will need ongoing care over the next several years, health sharing may not be a good match for you.
- Lack of Prescription Drug Insurance: Health sharing plans generally provide access to a generous prescription drug discount plan. But they do not provide prescription drug insurance.
- No Tax or ACA Subsidies. Unlike health insurance premiums, health sharing contributions are not tax deductible, and don’t qualify for ACA subsidies.
Altrua HealthShare Ministries is a well-established and one of the largest health sharing ministry organizations in the United States, serving thousands of members across Colorado and nationwide. Here’s a closer look at what Altrua HealthShare Ministries offers:
The CARE+ Plan is an affordable health sharing option for statutory employees, emphasizing coverage for major medical expenses like hospitalizations and critical illnesses.
It offers unlimited telehealth visits, mental health counseling, and accepts tobacco users with a surcharge.
The DPC DIRECT Healthshare Plan is a perfect health sharing option for Coloradans who are members of a Direct Primary Care plan (DPC).
DPC Members get unlimited primary care services at a flat monthly fee, with no copays or deductibles. However, DPC focuses solely on primary care, leaving out ER visits and specialist care.
That’s where DPC DIRECT comes in.
DPC DIRECT is designed specifically to pick up where DPC plans leave off. This plan supplements DPC plans by covering gaps and providing seamless sharing benefits with no billing surprises.
HSA SECURE is the only major health sharing plan that preserves members’ eligibility to make pre-tax contributions to a Health Savings Account – potentially allowing members to save thousands in taxes and healthcare costs.
It pairs a health sharing community with an HSA-qualified minimum-essential-coverage insurance plan. This combination offers substantial savings, tax advantages, and flexibility to individuals looking to reduce their healthcare costs.
A great match for families – especially if you can afford to make significant contributions to your family HSA each year, which maximizes the plan benefits.
MediShare is a prominent health sharing plan with over 250,000 members nationwide and a substantial presence in Colorado.
Founded in 1992, it was the first nationally-accredited health sharing organization in the United States. Medi-Share operates as a non-profit health sharing ministry organization with strong Christian principles.
Over the years, Medi-Share has helped members pay nearly $2 billion in medical bills.
netWell Healthshare is a leading health sharing membership plan in Colorado, offering residents an alternative to costly health insurance.
Health sharing organizations like netWell allow like-minded individuals to voluntarily share medical expenses while not functioning as traditional insurance. It’s essential to understand the distinction between health sharing and health insurance.
OneShare Health in Colorado offers an affordable alternative to traditional health insurance with a faith-based approach.
It provides freedom of choice in healthcare providers, telehealth services, and benefits such as maternity coverage and diabetic care savings. While there are waiting periods and limitations for pre-existing conditions, the flexibility and cost-saving opportunities make OneShare Health an attractive option for many residents in Colorado.
Sedera Health is a non-profit health sharing ministry organization that offers a cost-effective alternative to traditional health insurance.
It has gained popularity among Colorado residents, particularly those who don’t qualify for Affordable Care Act subsidies.
Universal Healthshare is a good solution for those interested in joining a non-denominational faith-based community.
The ministry was founded on the principles of Unitarian Universalism. Members agree to live healthy lifestyles in accordance with the plan’s Statement of Faith.
ColoHealth is one of just a handful of health insurance brokerage firms who can talk to you about all your health plan options in Colorado.
We’re not restricted to the handful of health insurance companies doing business in Colorado. We also represent all the top health sharing companies active in the state, as well.
To arrange a free consultation and quote, make an appointment with one of our excellent Personal Benefits Managers.
Here are some additional blogs for reference: The Colorado Health Insurance Open Enrollment Guide | Why Is Colorado Health Insurance So Expensive? | How To Have a Low-Cost Childbirth in Colorado | Colorado Residents: What To Do With Your Tax Refund in 2024
Frequently Asked Questions on Health Plans in Colorado
What is health insurance, and why do I need it?
Health insurance is a financial arrangement that helps cover your medical expenses. It’s essential because it provides a safety net for unexpected healthcare costs, ensuring you receive necessary care without substantial financial burden.
What is open enrollment, and when does it occur?
Open enrollment is a specific period when you can enroll in or make changes to your health insurance plan. In Colorado, open enrollment for individual health insurance plans typically runs from November 1 to January 15 each year.
What is a health sharing plan, and how does it differ from traditional health insurance?
A health sharing plan is a faith-based or non-profit organization that facilitates the sharing of medical expenses among members. It differs from traditional health insurance as it often has different eligibility requirements, coverage limitations, and may not cover all medical expenses.
Are health sharing plans available in Colorado, and who is eligible for them?
Yes, health sharing plans are available in Colorado. Eligibility criteria can vary among different plans, but they often require members to adhere to certain faith-based principles or shared beliefs. It’s essential to review each plan’s specific requirements.
What are the advantages of choosing a health sharing plan over traditional health insurance?
Health sharing plans can be more affordable than traditional health insurance especially for those who don’t get a large subsidy from the Affordable Care Act.
Health sharing also provides members with flexibility in choosing healthcare providers.
They may also align with specific religious or ethical beliefs.
What are the disadvantages of health sharing plans?
Health sharing plans may not cover all medical expenses, including some pre-existing conditions or specific treatments. They may also require adherence to a set of principles or shared values, limiting eligibility.
What are the essential factors to consider when selecting a health insurance plan in Colorado?
When choosing a health insurance plan in Colorado, consider factors such as monthly premiums, deductible amounts, coverage networks, prescription drug coverage, and whether your preferred healthcare providers are in-network.
How do I apply for health insurance through Connect for Health Colorado?
To apply for health insurance through Connect for Health Colorado, visit their website during the open enrollment period, create an account, and complete the application. You may also seek assistance from certified brokers or enrollment centers.
Can I change my health insurance plan after open enrollment?
In most cases, you can only change your health insurance plan or enroll in a new one outside of open enrollment if you qualify for a Special Enrollment Period (SEP). Qualifying life events, such as marriage, childbirth, or loss of other coverage, can trigger an SEP.
What are some essential tips for comparing health insurance plans effectively?
When comparing health insurance plans, focus on your anticipated healthcare needs, evaluate the total cost of the plan (including premiums, deductibles, and out-of-pocket costs), check the provider network, and review the plan’s coverage for specific treatments or medications you may require.
Can I have both a health sharing plan and traditional health insurance simultaneously?
It’s typically not advisable to have both a health sharing plan and traditional health insurance at the same time, as this may lead to complications in coverage and payments. Review your needs and preferences to choose the most suitable option for your situation.
Christine Corsini is a health insurance and medical cost sharing expert, and a Personal Benefits Manager at ColoHealth. Her goal is to help people embrace life’s amazing possibilities by staying healthy, saving money, and making the best decisions when it comes to healthcare.