Don’t understand or not satisfied with your current health insurance plan? You are not alone. According to a 2010 study by The Colorado Trust, 14% of San Luis Valley residents are underinsured, meaning that their health coverage is inadequate in that it does not guarantee that an individual will have the ability to access or pay for needed health care services.
Besides the underinsured, 27% of Valley residents lack health care coverage according to the 2011 Community Health Survey conducted by the Rocky Mountain Prevention Research Center. Individuals who are underinsured or uninsured have a significantly more difficult time navigating and utilizing health care services.
Come October, health care leaders across the state hope to improve these individual’s ability to access and pay for health care services with Connect for Health Colorado (C4HCO), the state’s first open, competitive marketplace for individuals and small employers to compare and purchase health insurance. The goal of the new online marketplace is to increase access, affordability and choice, for individuals and small employers looking to purchase health insurance in Colorado and to provide a simpler, smarter shopping experience.
Patient Financial Service Manager Speaks Out
Cayetana Quintana, Patient Financial Service Manager for the SLV Regional Medical Center, is excited for the new resource. “I think it will have a huge impact on the uninsured and underinsured population in the Valley. It will provide another option for the individuals and families I serve,” said Quintana. “Also, many more of our patients will be covered by Medicaid, which has expanded in Colorado to cover patients at or below 133% of the (federal) poverty level. This will have a large impact on peoples’ ability to get and afford services here.”
Accessible at www.connectforhealthco.com, C4HCO was established by a legislative bill passed in 2011, SB 11-200, which was developed with the idea that Colorado should create a new service that will increase competition and choice in the marketplace for the benefit of individuals, families and small employers across Colorado. Start-up funding comes from the federal level through the Patient Protection and Affordable Care Act passed in 2010.
Currently, ten different insurance agencies are participating and will offer over 150 different plans on the marketplace. All health plans offered through the C4HCO will provide a minimum set of benefits and services including ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care.
Four Categories of Coverage
All insurance plans sold on the exchange will be divided into four different categories: bronze, silver, gold, and platinum. Bronze plans will cover the cost of about 60 percent of medical services and will have the lowest monthly premiums. Platinum plans will cover the cost of about 90 percent of medical services and will have the highest monthly premiums. Silver and gold plans will cover 70 and 80 percent of costs, respectively, and premiums will be higher than bronze plans but lower than platinum plans.
Connect for Health Colorado will include a support network of Customer Service Center Representatives, certified Health Coverage Guides and licensed brokers, to help Coloradans find the best health plan for their needs. Consumers will have the ability to shop and compare plans online, sit down with a Health Coverage Guide or broker, or speak to a Customer Service Center Representative over the phone. The Health Coverage Guides will also help individuals determine if they are eligible for Medicaid.
Patty Fontneau, Executive Director and Chief Executive Officer of C4HCO, explains how much certain plans will cost based on age and location. “Preliminary filings from health insurance carriers show that monthly premiums for a 21-year-old living in Denver from the majority of carriers will range from $146 to $234 for bronze plans and from $192 to $279 for silver plans, before cost-reductions based on income. Monthly premiums for a 40-year-old living in Denver from the majority of carriers will range from $186 to $299 for bronze plans and from $245 to $357 for silver plans.”
By making health insurance more accessible and affordable, Valley residents, especially children, will have better health throughout their childhood and adult life. Studies have shown that compared to insured children, uninsured children are five-times more likely to have an unmet need for medical care, they are three-times more likely not to get a needed prescription drug, and less likely to receive essential preventive services such as immunizations, dental and vision care.
For more information, visit Connect for Health Colorado’s website at www.connectforhealthco.com.