What is the difference between public and private health insurance?


State Public Health Insurance
Private Health Insurance
Employer-Sponsored Health Insurance
Type of Insurance Public health insurance programs run by the state of Colorado are Medicaid and Child Health Plan Plus (CHP+). Health insurance plans are run by private insurance companies and you may be responsible for paying for all or some of your coverage. Health insurance plans are run by private insurance companies and are partially paid for by your employer.
When to Enroll Applications are accepted at any time during the year and eligibility is determined year-round. Plans have defined open enrollment periods. There are also special enrollment periods when certain triggering events occur, such as marriage or the birth of a child.The Connect for Health Colorado Marketplace open enrollment period for 2014 ends March 31. Employers providing health insurance will typically have an annual open enrollment period for their employees to enroll in the plan.  The dates and length of the period are determined by the employer, but will correspond to the start of coverage.  For example, if coverage starts January 1st, the open enrollment period will likely be in October, November or December.  Check with your employer for details.There are also special enrollment periods when certain triggering events occur, such as marriage or the birth of a child.
When Coverage Starts Coverage begins the 1st of the month that the application was received. For example, if you apply on February 15, 2014, if eligible, your coverage will be back dated to February 1, 2014. Coverage begin dates may vary depending on the insurance plan.For all plans purchased by the 15th of the month, coverage begins the first of the following month. For example, if you purchase you plan on February 10, 2014, your coverage will begin March 1, 2014.If you purchase a plan after the 15th of the month, coverage begins the first of the next following month. For example, if you purchase your plan by February 20, 2014, your coverage will begin April 1, 2014. If you purchase your plan through your employer, you will need to ask your employer about when your coverage begins.
Cost Medicaid and CHP+ are free or low cost health insurance coverage for Coloradans who qualify. Some Medicaid and CHP+ clients may have to pay enrollment fees and co-payments (a flat dollar amount fee for a service). Private health insurance plans are paid for through premium payments. If you do not purchase your plan through an employer, the insurance company should provide information about the frequency and type of payment required for premiums.  If you do not have this information, ask the insurance company.In addition to premiums, the healthcare services provided will likely also require payments, typically either co-payments (a flat dollar amount fee for a service), co-insurance (a percentage of the fee for a service), or the entire fee for a healthcare service (if you have a plan that requires payment of all costs, aside from preventive care, until you meet a deductible amount). If you purchase your plan through your employer, ask about how and when premiums are deducted from your pay. In addition to premiums, the healthcare services provided will likely also require payments, typically either co-payments (a flat dollar amount fee for a service), co-insurance (a percentage of the fee for a service), or the entire fee for a healthcare service (if you have a plan that requires payment of all costs, aside from preventive care, until you meet a deductible amount).
Health Care Providers Medicaid and CHP+ are the largest insurance providers in the state. A majority of health care providers in Colorado accept public health insurance.You will need to contact the individual provider to confirm they are taking new patients. To find providers who accept Medicaid and CHP+ clients click here. Providers – doctors, hospitals, and others who provide healthcare services – may vary depending on the health insurance plan and where you live.  To find the providers who participate in the plans on Connect for Health Marketplace click here. If you did not purchase your plan from Connect for Health Colorado, contact your insurance company to find out about the providers available in your plan. Health care providers – doctors, hospitals, and others who provide healthcare services – may vary depending on the health insurance plan and where you live. To find out about the providers available in your plan contact your health insurance company.

 

For more information on Federal health insurance programs see Medicare, VA Health Services, TRICARE and Indian Health Services.