Health Insurance 101
Health insurance: helping you pay for care
Health insurance allows you to share the costs of care and other health-related costs with an insurance company. In exchange for a premium (you pay a certain amount to the insurance company, usually on a monthly basis), your health insurance contract requires a health insurer (the health insurance company who operates your chosen plan or plans) to pay some or all of your health costs during the year covered by your contract.
Most Coloradans can purchase or change their health insurance during Open Enrollment, a period starting in November each year in which you don’t need any kind of special approval to sign up for the plans of your choice. To get health insurance outside of the Open Enrollment period, you will generally need to experience a qualifying life event, after which you will have 60 days to enroll (called a Special Enrollment Period).
Why is health insurance important
Health insurance can help you stay healthy
All health plans you can enroll in through Connect for Health Colorado cover 10 essential health benefits, as well as a set of important preventive services. This means preventative services are available to you at no extra cost (on top of your premium), even if you haven’t met your deductible.
- Visit your doctor: Things like annual check-ups and some health screenings are covered when delivered by a doctor or other provider in your plan’s network.
- Better health = more savings: Preventive services help keep you healthy so you save money by preventing illness or other doctor visits during the year.
Health insurance can protect you from debt
Having health insurance can help you pay for high, unexpected healthcare costs. Without insurance you could face these costs entirely on your own.
- 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.
- Every health insurance plan sold through Connect for Health Colorado has an out-of-pocket maximum. Once you’ve spent the out-of-pocket maximum, your insurance will pay 100% of your covered healthcare costs.
Finding a health insurance plan that’s right for you
Because every individual and family is unique in what they want and need in their health insurance, there are many different types of health insurance plans. Understanding the basics of how each type of plan works, what you pay and when, and the tradeoffs between high and low-deductible plans will help you ensure that your plan is the right one for you.
All plans sold through Connect for Health Colorado are required to cover a full package of benefits. These are listed in the plan’s Summary of Benefits and Coverage (SBC). However, plans available may vary a great deal in the:
- Number of hospitals and doctors you can go to (in-network)
- Way they share costs with you (copay v. coinsurance)
- Additional benefits they cover beyond what is required
How to compare plans
You can compare costs and benefits of different plans, review what’s available from each provider offering plans through Connect for Health Colorado, and even receive estimates on what you could receive in financial assistance by inputting your information into our Estimate and Explore Tool »
Health insurance terms to know
Copay
For health services with a copay, you pay a fixed amount for the care you receive.
Coinsurance
For health services covered by coinsurance, you pay a percentage of the total cost of a covered medical service (after you have met your deductible).
Deductible
For most types of healthcare, you may have to pay the amount of your deductible before your insurance plan will start to pay for some of the costs of getting care.
Learn more about how health insurance works here: Insurance Costs Explained »