Hey there, wonderful people of Denver’s LGBTQ+ community! Let’s talk about something super important but often pushed to the back burner – choosing the right health insurance. We get it; it can feel like a maze with all those plans and terms thrown at you. And, being a part of our vibrant, yet diverse community, we’ve got some specific things to think about when picking a plan – whether it’s finding LGBTQ+-friendly healthcare providers or ensuring mental and sexual health are well-covered. Worry not! This easy-going guide is here to walk you through the health insurance puzzle, making sure you find something that’s not just a safety net but a snug, reassuring embrace that gets YOU. So, let’s dive into the nitty-gritty together and figure out how to choose a health plan that truly fits your unique and beautiful self, right here in our beloved Denver.
How to Choose the Right Insurance for You
At Gay Denver, we know how confusing and frustrating shopping for and buying health insurance can be. The key is finding the right plan for you or your family and the specific/unique needs you may have!
This blog will outline what you’ll need to consider when shopping for a plan and how to buy one through Connect for Health Colorado.
Before You Buy
The best way to save money on health insurance takes a little extra work, but will be worth it in the long run. Not all health plans are the same; some have cheaper prescriptions, some have free mental health, and some even have smaller maximum out-of-pocket (the most you can pay in a year for health services). There are trade-offs for each type. Here’s what you need to do:
- Gather all your prescriptions and note how much you currently pay for them. Or write down any prescriptions you’d like to have in the future, like HRT. Many plans have a drug “formulary” where you can search their system to make sure they cover it, but you’ll do that part when you’re shopping.
- Make a note of any health concerns or diagnoses you may have or how often you’ve gone to the doctor in the last few years.
- Are you wanting to get any surgeries soon? If so, make sure to take that into consideration.
- If you’re super healthy with few needs, your needs will differ from someone getting bottom surgery and on Testosterone.
- Do you want to see a counselor? Do you struggle with depression and might need an inpatient stay at some point?
- Do you need frequent STI testing or HIV/AIDS treatment?
Write down what’s relevant to you and have it handy. You’re going to need it!
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Getting Started and Checking for Subsidy Savings
Visit connectforhealthcolorado.com and either create an account or log in. From there, it will prompt you to fill out your information like your social security number (if you have one), birthday, full name, etc.
During this process, it will ask you if you’d like to see if you qualify for financial aid. Select yes, and it’ll ask you for your yearly earnings. Financial aid for health coverage, also known as subsidies, is a type of financial assistance that will lower monthly premium costs or reduce medical costs. The Advanced Premium Tax Credit lowers your monthly payment, and Cost Sharing Reduction subsidies decrease the price of the services you’d receive, like prescriptions and doctor visits. Qualifying for subsidies depends on income, family size, and the cost of health insurance in your area. About 75% of people who buy plans through Connect for Health Colorado get financial assistance! You can even check if you qualify before you shop if that’s more your jam.
Once you’ve entered all your information, if you qualify for a plan, you will get a list of options and what they’ll cost you. Here’s where things can get confusing, but don’t worry, we’re here to help! You can select multiple and compare them side by side before you choose.
Selecting the Right Plan
Each month, no matter what health plan you choose, you will pay a monthly charge called a premium. The premium amount varies depending on your selected plan, age, where you live, and if you’re a smoker. Plans also have costs for specific services like going to the doctor or getting your prescriptions filled.
A smart way to approach saving on health insurance, NOT just by comparing monthly premiums. It’s by evaluating health plans based on how much you will pay over the year when you add up premiums and the costs you pay for medical services and drugs. This is where the information you gathered above comes in handy.
Even if two plans have the same premium, if one requires you to pay a lower cost for doctor visits and prescriptions, it could save you money in the long run.
For example, some plans cover generic prescription drugs for free, saving you hundreds of dollars annually compared with other plans with the same monthly premium.
Here are a few points to consider in evaluating which plan level might work best for you:
- Does the plan allow you to access the services you use most (such as specific prescriptions or needing surgery) at a cost that works for you?
- What’s the copay (the flat fee you pay each time you see the doctor or buy a drug) or coinsurance amount (the percentage you pay for services after you’ve met your deductible) for the medical services you use most?
- If you are in good health and don’t anticipate any major medical procedures, consider a high-deductible plan that costs less monthly than plans with a lower deductible.
- If you have a specific doctor you love, check that they’re in-network with your desired plan.
You Could Save Big by Opting Out of Your Employer’s Health Plan
Even if you have a job that offers health insurance, signing up for their plan may cost more than a plan you could get through Connect for Health Colorado. Depending on the type of benefits the company plan offers and how much your employer contributes, it might be more expensive than getting insurance on your own. Your company may think everyone wants a health plan loaded with various benefits. But these might be right for them, not you. That leaves you paying too much for a “rich” health plan when all you need are the basics. This is what we call being “over-insured.” During the open enrollment period for individual health insurance, look at the individual health plans offered on the open market—you might find one with benefits and a price that fits you better.
Consider Insuring Your Family Separately
Your company may contribute financially to your insurance premium cost, but they may not contribute to your spouse’s or kids’ plans (if they offer it to them at all). In that case, it makes sense to shop for private health insurance for your family members to see if other plans fit their needs at a more appealing price point.
Summary
A lot more goes into selecting a health plan than you may have thought. When it comes down to it, getting health insurance is paying for peace of mind and coverage for emergencies and the routine services you may need. Using Gay Denver’s guide above is a sure way to ensure you get the right coverage for yourself and your family.
