Denver, Colorado Individual & Family Health Insurance
Our team of professionals at Gold Health & Life can sort through all the options and help you choose the right Colorado health insurance plan for your specific needs.
When choosing your health plan it's vital to make the proper decision. Important questions to ask yourself are:
- Are my doctors in the Carrier's network?
- Are my medications included in the health plan's prescription drug list?
- What is the difference between my deductible, out of pocket, copays and coinsurance?
- Do I qualify for a tax credit towards my premium?
Simply put, health insurance is protection against medical costs. With the changing laws and the cost of healthcare on the rise, most people can't afford to take chances with their health and the health of their family members. Although Colorado health insurance policies differ, they typically provide either direct payment or reimbursement for expenses associated with preventive care, injuries, surgical procedures, hospital expenses, urgent care, and can cover prescription drugs.
If your employer does not offer an adequate health benefit package, or you are self employed, unemployed, retired, or a student, we can help you sort through the maze of Colorado Health Insurance options and find the right plan at a price you can afford. Gold Health & Life will help you understand the different types of health insurance choices for you and your family.
Health Insurance Glossary of Terms
Network: The Facilities (hospitals, clinics, etc.) and Providers (doctors) your health insurer has contracted with to provide health care services. Contact your insurer to find out which Facilities and Providers are In-Network. They may also be referred to as Preferred Providers or Participating Providers. Out-of-Network: There are no out-of-network benefits on Individual Plans in CO aside a life or limb threatening emergency. You will be treated anywhere as in-network.
Premium: The monthly amount you pay for your health insurance plan. This does not count towards your deductible, copayment, or your co-insurance. Failure to pay your premium could result in a loss of coverage, so always be sure to make timely payments!
Deductible: The amount you owe for those health care services covered by your insurance plan before your insurance begins to pay. For example, if your deductible is $1,000, your plan won't pay anything (except annual preventive visits and service copays) until you've paid the first $1,000 out-of-pocket, then your coinsurance kicks in until your annual out of pocket is reached. The deductible may not apply to all services.
Embedded Deductible: In an embedded deductible plan, cost sharing for a member will begin when that member reaches their individual deductible or when a combination of members reaches the family deductible.
Copayment (or Copay): A dollar amount you pay as your share of the cost for a medical service (doctor/hospital visit) or supply (prescription drug). For example, you might pay $20 or $50 for a doctor's visit, lab work, or prescription drug.
Co-Insurance: Your share of the costs of a covered health care service after you meet your Deductible. For example, if your co-insurance is 20%, you've already met your annual Deductible, and the allowed amount on your test or procedure is $1,000, then your co-insurance payment would be $200 while your health insurance plan pays the rest.
Out-of-Pocket Maximum: The most you pay during a policy period (usually a calendar year) before your health insurance plan starts to pay 100% of covered, in-network services. This includes deductibles, co-insurance, and copayments for a qualified medical expense.
Health Savings Account (HSA): A Health Savings Account is like a personal savings account, but the money is used to pay for qualified medical expenses. You have the option to deduct a portion of your pre-tax earnings each pay period to go directly into your HSA account.
Explanation of Benefits (EOB): A summary of health care charges that your health insurance Carrier sends you after you see a provider or get a service. It is not a bill - it is a record of the health care you received and how much your provider is billing your health plan.