During the upcoming open enrollment period, Coloradans will have an exciting new resource to help them choose plans on Connect for Health Colorado’s health insurance marketplace. The Quick Cost and Plan Finder tool is a collaboration between CIVHC and Connect for Health Colorado and allows marketplace users to estimate annual total costs and premiums by health plan offering.
The Quick Cost and Plan Finder asks users to fill in basic personal information, including age and gender, and to self-report their level of health care usage according to three levels, high, medium, or low. Shoppers then can enter preferred provider or hospital names and prescription information as criteria when the tool searches for applicable plans. Once all questions are answered, the tool provides the user with a listing of all of the plans that meet their criteria. Displayed with the plan information are premium estimates as well as total out-of-pocket cost estimates.
How is the out-of-pocket cost calculated?
Using 2014 commercial claims from the CO APCD, CIVHC calculated the average annual total cost of care and health service utilization for Coloradans in different demographics, including age and gender. This information was provided to Connect for Health Colorado, and forms a portion of the foundation of the tool. Based on what level of health care usage the user reports and the other demographic information entered, an estimated out-of-pocket total is calculated. The tool then adds this number to the annual premium amount, providing a yearly cost estimate. Depending on plan design, out of pocket costs may include coinsurance, copays, and deductibles.