Cost-Sharing Reductions

If you are eligible for Premium Tax Credits, you may also be eligible for additional savings in the form of cost-sharing reductions. Cost-sharing reductions are available to those with low-to-moderate income who qualify and who enroll in a silver plan through Connect for Health Colorado. Health insurance plans typically require some form of cost sharing (also called out-of-pocket costs) when you receive covered healthcare services. Cost-Sharing Reductions help you save on these expenses, which are in addition to your monthly premium and come in a variety of forms, including:

  • Copayments: Set dollar amounts for covered services
  • Coinsurance: A percentage of the allowed cost for covered services
  • Deductibles: Set dollar amounts that enrollees must pay before their plan starts to cover the service or a group of services

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If your income, as an individual, is between $15,802 and $29,701, there are three different discount levels that reduce the amount you pay when you receive care. The lower your income, the bigger your discount. But remember, if you are eligible for Cost-Sharing Reductions, you MUST purchase a silver-level plan to take advantage of these out-of-pocket savings.

 

Discount Levels

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Additional Ways to Save

It pays to compare plans, especially if you are a current customer and saw your rates increase for 2017. Consider switching to the lowest-cost plan in your current metal tier. That alone can reduce the amount of your increase, on average, by close to half.

In addition, there is an opportunity to reduce monthly premiums by shopping around and comparing plans but the premium amount should not be your only consideration. You should factor in out-of-pocket costs such as co-pays, deductibles and prescriptions, as those will affect what they pay for care through the course of the year. You may pay less each month, but owe more when you need care. Our expert Brokers can help evaluate benefits that meet your health and financial needs.

Be insurance smart and select a plan that includes your preferred doctor and hospital as “in-network.” Going to a doctor or facility that is considered “out-of-network” will cost you more. Also, make sure that your plan covers your preferred medications. Use our Quick Cost & Plan Finder tool to browse plans that include your preferences and get a sense of your out-of-pocket costs. We also offer some helpful tips on how to use your health insurance wisely.