DENVER – Coloradans without health insurance found out Friday what it will cost them to comply with the insurance mandate taking effect next year.
The Division of Insurance released rates Friday of plans that comply with the federal health-care overhaul. Eighteen insurance companies will offer 541 separate plans for individuals and small groups.
For a 40-year-old individual customer, monthly premiums will range from $177 a month to $774 a month. The wide range of rates is because premiums depend on the level of coverage and where in the state a person lives. By 2015, insurers will also be charging different rates for smokers and nonsmokers.
Residents in Southwest Colorado fall into Rate Area 10 (West) in which there are six plans offered for individual customers. A 40-year-old with catastrophic coverage (the cheapest) could pay from $228 to $418 a month.
Colorado will open a marketplace Oct. 1 to help customers shop for insurance. The health insurance exchange, called Connect For Health Colorado, has hired “navigators” to explain the health insurance options at health fairs and community events, and the exchange has also taken out TV ads to get the word out about shopping for insurance.
Kevin O’Connor, a navigator under another name – health coverage guide – at San Juan Basin Health Department, said it’s logical that health costs vary according to locale.
The availability of provider networks is important, O’Connor said. If a patient receives care from an out-of-network provider, part or all of the cost could be borne by the patient, he said. A patient in the Kaiser Permanente network who receives service in Southwest Colorado is an example, he said.
“Not all networks are available in all places,” he said.
O’Connor cautioned about basing decisions on cost alone.
“You should look out for what’s best for yourself or your family,” O’Connor said. “Rates don’t take into account tax credits, which can lower cost substantially.”
Colorado has about 716,000 people without insurance. Many of them will be eligible for free health care through Medicaid, or subsidized health insurance depending on their incomes. Coloradans who aren’t eligible for free health care but choose to skip health insurance altogether will be fined $96 next year, with fines going up dramatically in subsequent years. For now, health officials are hoping to lure the uninsured into the system, talking up new benefits under the overhaul.
For example, young and healthy customers can now find cheaper premiums for catastrophic health insurance. Health officials are trying to soften the sticker shock by talking up additional benefits those young and healthy consumers will see under the new health-insurance plans, such as lower out-of-pocket costs and no coverage maximums if they get sick or injured.
“While it is tempting to compare the costs for the new plans to current ones, it is important to remember that these are new plans with new benefits and new requirements, so it is not an ‘apples to apples’ comparison,” Interim Insurance Commissioner Doug Dean said in a statement.
The rates released Friday show the complicated decisions facing Colorado’s uninsured.
First, rates and options will depend on where in Colorado a customer lives.
Let’s say 40-year-old customer seeking individual insurance through the exchange wants a “bronze” plan, meaning insurance would cover 60 percent of his or her health-care costs. That 40-year-old would have 16 insurers to choose from, with monthly premiums from $186 to $364, if he or she lives in Denver. The same customer living in Grand Junction would have just eight insurers to choose from, with monthly premiums ranging from $237 to $400. And if the same customer is living in Greeley, he or she would have 13 insurers to choose from, with monthly premiums ranging from $177 a month to $296 a month.
A 40-year-old customer who wants to use the exchange to buy an individual “platinum” plan, in which insurance would cover 90 percent of his or her costs, has even fewer options. That customer would have two insurers to choose from in Denver, one insurer to choose from in Colorado Springs, Pueblo and far Eastern Colorado, and no insurers at all through the exchange in Boulder, Fort Collins, Grand Junction or Greeley.
The Insurance Division also approved rates for small group plans, affecting businesses with fewer than 50 employees. For the least expensive small group plan, monthly base rates for premiums range from $224 with Kaiser Permanente to $1,003 with Humana Insurance Co.
State officials insist Coloradans will have plenty of help through the state exchange making sense of the new health-care landscape.
“As Colorado consumers and small businesses shop for insurance this fall, they will be able to choose from a great variety of health plans,” Dean said.