If you buy health insurance on your own — or if you own a small business and are trying to pick a health plan for your employees — you have almost run out of time to get coverage for next year.
The deadline to select a plan that will kick in Jan. 1 is Friday — Dec. 15. (Open enrollment continues until Jan. 15, but plans bought after Friday won’t start until February.) If you are stuck in the throes of insurance indecision, do not fret, for we at The Sun have you, uh, covered.
Last week, we hosted a panel discussion with three health insurance experts to help you choose the plan that’s best for you.
You can watch the whole thing here:
But, if you’re just looking for the highlights, here are a few takeaways.
You better shop around
It can be so tempting to purchase the first plan that pops up on your search results. But that may not be the best choice.
“If you have a doctor that’s important to you, you want to make sure that they’re in the network of the plan that you’re going to be choosing,” said Michael Conway, Colorado’s insurance commissioner. “You also want to make sure that if you have any prescriptions, that those prescriptions are covered by the plan that you’re going to choose as well.”
“The core point, folks, is to go shop,” Conway added. “There’s a ton of assistance for you both from the federal government and the state of Colorado to help you afford your health insurance premiums. And by shopping you might be able to just find a cheaper plan within the same metal level that you were in this year.”
Claim what you are owed
Speaking of financial assistance, it’s always a good idea to check whether you are getting everything you can. Colorado has new state-funded subsidies that can help lower-income individuals and families pay out-of-pocket costs. And, if you haven’t checked in a couple of years, you may find that you are eligible for expanded federal subsidies that first kicked in during the pandemic.
“It doesn’t hurt to check,” said Kevin Patterson, the CEO of Connect for Health Colorado, the state’s insurance exchange. “That has been the most stubborn data point I’ve seen. Everybody’s like, ‘Oh, I make too much for that.’ And I say, ‘Do you?’”
“If they’ve just been renewing in the same plan for a number of years, they may actually be eligible for subsidies that they’re just leaving on the table,” Conway said.
The only place you can apply for subsidies is through the Connect for Health Colorado website. Use the Quick Cost & Plan Finder to see if you are eligible for assistance and also see what plans are available in your area.
Look at the whole cost of coverage
The vast majority of people who purchase health insurance do so based on picking the least-expensive premium price. This is not the best way of doing things.
The reason is because plans with lower-priced premiums are more expensive when you actually have to use them — they come with higher deductibles.
“It’s kind of like saying you own a car but you’re only making the monthly payment — you don’t have to get the oil changed or put new tires on it or put gas in it,” Patterson said. “There’s other expenses that come with the total cost of ownership. And I think you really have to think of health insurance in a very similar fashion.”
So try to think about not just your monthly budget when buying insurance but also how likely you are to use it and how much you can afford to pay out-of-pocket at any given time. That will help you make a smarter decision that could save you money in the long run.
Be honest about your needs
OK, how do you estimate what your health care needs will be, especially if you don’t have ongoing health conditions or planned procedures? You have to think like an actuary and come up with an honest prediction for the unexpected.
“I’m looking at the family composition — if they’ve got littles, I’m just gonna say right now, they’re accident prone,” said Meagan Fearing, a health insurance broker and a past president of the brokers’ group NABIP Colorado. “Beyond that, I’m also asking questions around how many times were you guys sick this year? How many times did you take off from work? … Do you have anything that’s kind of been nagging at you?”
Look at prior years’ health spending and use an average of that as a baseline. Then start doing the math: Does 12 months of a lower premium make sense if it means you’re paying most of your annual medical bills out-of-pocket before you hit your deductible? Or could you save money by paying more per month in premiums if it means you reach your deductible earlier?
Know when you need help
Even in these final hours, health insurance brokers and Connect for Health assisters are available to help you navigate the system and make the best choice. Even better, they work at no cost to you — and brokers can also be useful after you’ve selected your coverage to help you make sure you get the most out of your plan.
Connect for Health has a broker lookup tool, as well as a scheduling tool for getting help at a certified assistance center.
“A broker can really help you make a smooth trip through the process,” Fearing said.