New for 2023 – Colorado Option Plans
The introduction of this plan type is because of the Colorado Option law (HB21-1232). This law aims to lower the costs of premiums and many health care services.
Some highlights of what’s new or different about the Colorado Option plans:
Access to many services at no cost
Even before you meet your deductible – examples include:
- Doctor visits when you are sick or injured
- Mental health care office visits
- Prenatal and postnatal doctor visits
- Diabetic supplies
Fixed costs across insurance companies
Costs to go to the doctor for the most common services or to fill a prescription are the same for all Colorado Option standard plans within each metal tier, so it’s easier to know what you’ll pay. Plus, the copayments, deductibles and out-of-pocket maximum amounts are the same as well. Learn more about metal tiers »
Designed to be inclusive
Colorado Option plan networks include Certified Nurse Midwives and more community providers than before. The plan networks must also support its non-English speaking enrollees through enhanced language access and provider directory requirements.
Defining HMOs, EPOs and HSAs
Comparing HMOs and EPOs
|Healthcare considerations||HMO (Health Maintenance Organization) plans*||EPO (Exclusive Provider Organization) plans*|
|Required to select a primary care physician (PCP)?||Yes||No|
|Referrals needed to see a specialist?||Yes (With some exceptions)||No (With some exceptions)|
|Number of doctors and hospitals that are in-network||Generally smaller||Generally larger|
|Able to use a Health Savings Account (HSA)?**||Only if the plan is also a HSA/ High Deductible Health Plan||Only if the plan is also a HSA/ High Deductible Health Plan|
* Colorado Option plans may be either an HMO or EPO.
** Health Savings Accounts (HSAs) can not be used for the Colorado Option plans.
HSA Plans (Health Savings Account)
Both HMO and EPO plans can be high deductible health plans that are designed for people with a health savings account (HSA).
- With an HSA plan, you are eligible to open a Health Savings Account through your bank or other financial institution that allows you to set aside money on a pre-tax basis to pay health-related expenses. The tax savings allows you to reduce your overall healthcare costs. (Connect for Health Colorado does not open an HSA for members enrolled in an HSA-eligible plan. AND A Health Savings Account can be used ONLY if you have an HSA Plan – sometimes referred to as a High Deductible Health Plan or HDHP.)
- HSA plans tend to have lower monthly premiums and higher deductibles.
- HSA plans do not pay for medical costs until the deductible is met, meaning you are responsible for 100% of the cost of going to the doctor until you reach your deductible.