1. Get quotes from multiple Colorado health insurance companies
Premiums for health insurance in Colorado can vary greatly, sometimes as much as 50% for similar plans. When comparing plans, be sure to look at the benefits as well as the monthly premium. Make sure your plan provides adequate catastrophic coverage, preferably at least two million lifetime maximum benefit.
2. Choose a higher deductible
The higher the deductible, the lower the monthly premium. Keep in mind, you will be responsible for medical bills out of your own pocket until this deductible is reached. However, there are plans that have copays before the deductible for office visits, prescription drugs, or accidents.
3. Add the coinsurance to your out-of-pocket total
Coinsurance is the amount the health insurance company will pay after you meet your deductible, and must be figured into your total exposure. Most companies will pay 80% of the medical bill after the deductible up to an annual maximum of typically $5000 to $10000. Medical bills in excess of this annual maximum will be covered at 100% by the insurance company. Some companies offer 50% co-insurance plans which may lower the monthly premium, but if you have a big claim, these plans can leave you with too much exposure.
Most importantly, make sure there is a limit on the coinsurance. Companies like MEGA Life and Health or Mid-West National have an option to cap the coinsurance, called the “Accumulated Covered Expense” (ACE) Rider. Even when the option is selected, it can leave you with an extra $15,000 to $20,000 financial exposure – way too much for what they charge for a policy like that.
4. Make sure the policy covers the doctors you need
Most plans contract with a network of “preferred providers”. These “PPO” plans pay more of the medical cost if you use the services of doctors within this network. If go to doctor or hospital outside the network, the insurance company may cover only part of the bill. A quick search of network providers for an insurance company, or a call to your doctor asking them which companies they bill will be plenty.
5. Consider separate policies for individual family members
If your family has different medical needs, one family member may prefer a more comprehensive plan while another may only need a catastrophic plan like an HSA. Or, if one member of the family has underwriting concerns or is unable to get an individual/family plan, it may be better to have them get a guarantee issue plan like Cover Colorado while the rest of the family gets a much lower priced individual/family plan.
Child only plans
Coverage for children under the age of 18 are relatively inexpensive. Parents who are relatively young and healthy might be able to save money by buying a higher deductible plan for themselves while still providing comprehensive coverage for their children with child only plans..
6. Coverage offered through an employer
Employers providing health care benefits will pay all or part of the premium for the employee but often do not contribute towards the dependents. Adding these dependents to the employers plan may be the responsibility of the employee and can be expensive. If the dependents are relatively healthy, it may save money to purchase an individual or family policy separate from the employers plan.
7. COBRA Alternatives
COBRA is a continuation of an employer sponsored plan for a former employee where the premiums are usually paid entirely by the participant. If the COBRA participant is relatively healthy, they can usually save money by purchasing an individual policy or short term health insurance instead of accepting the COBRA plan. Keep in mind, that the insurance company may refuse to provide coverage based on past health history. Therefore, those with serious health issues or expenses should stay with their COBRA option or enter a high risk pool, like Cover Colorado.
8. Consider a Health Savings Account (HSA)
With an HSA, you can set aside money in a tax-sheltered, interest-earning account that you can draw on to pay most medical expenses. Because it works with a high-deductible health plan, you pay less premiums than you would with a more comprehensive health plan. In addition, the savings you accrue minimize the risk of not being able to cover unexpected medical bills.
9. Minimize your chances of being denied coverage by the insurance company
Colorado offers health insurance for those unable to obtain health insurance from the traditional carriers due to serious health issues such as AIDS, cancer, major heart disease, diabetes, or other chronic conditions. These high risk plans can be expensive and therefore it is beneficial to qualify for the plans offered by the insurance companies if possible. Decline rates can be as high as 60 percent and often individuals without serious issues could have been approved had they provided an adequate explanation of past medical history. For example, be sure to explain clearly when condition has been resolved and requires no further treatment or medication.
10. Government assistance programs
Those at or below the poverty level have access to government assistance, but many people are unaware that some states offer programs for those above the poverty level as well. Usually, this assistance is in the form of a subsidy that will pay part of the premiums for traditional health insurance.
Watch out for too-good-to-be- true offers
A company offering coverage regardless of your health status and at very low rates should be a red flag. Also, make sure the plan offers protection for catastrophic coverage in the event a large claim is filed. Often plans with very low rates are discount programs and not insurance. Read the Colorado Department of Insurance warning on discount health plans.
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