What Healthcare Options Are Available in Boulder, CO?

How to Determine the Right Healthcare Plan for You in Boulder, COThose looking for healthcare in Boulder will have no end of potential options. From acclaimed hospitals to major insurance carriers, residents of the city can map out a healthcare plan based on their individual needs. Those hoping to determine the right type of coverage should keep the following in mind before deciding.

Understanding the Plans

Much like every other kind of insurance, healthcare is broken down based on how much treatment a person will need over the year. For example, young and healthy people may want to look into a major medical HMO plan. These basic, affordable plans come with the downside of a high deductible, meaning they won't cover smaller procedures or treatments. Individuals may need to spend up to $10,000 (or more) before their health insurance begins to pay for anything. However, major medical plans will also cover treatment for severe accidents and emergencies once the deductible has been met.

Considering medical bills can easily reach into the six figures for a catastrophe, even a high deductible may be a small drop in the bucket compared to the total costs. Conversely, anyone who anticipates needing more medical care can opt for a more comprehensive plan. Finally, those who travel often will want to take into account the emergency care they'll receive.

Payments and Premiums

Boulder, CO is covered by a number of major carriers, including Kaiser, Cigna, and Anthem BlueCross. Open enrollment for insurance lasts from Nov 1 - Dec 15, though qualifying life events give people the option to sign up at any time. As individuals review the terms of each plan, it's important to keep in mind both budget and personal freedoms. A more comprehensive plan will certainly cost more than a major medical plan, but individuals may end up spending less overall if they anticipate regular trips to the doctor.

Types of Plans

Health plans are broken down into categories:

  • HMO: HMO plans are composed of a network of doctors in the Boulder area. The insured is assigned a primary care physician who will need to approve of any additional treatment options (e.g., a specialist, etc.).
  • PPO: A PPO plan also has a network of doctors, but it does not require a primary care physician or special approval.
  • FSA: A savings account plan will set money aside (usually deducted from wages) to be used however the insured sees fit. Some companies allow unused funds to roll over to the next year.

Choosing a plan means taking into account certain considerations. An HMO may be less expensive, but the frustration of not being able to see a specialist may be worth opting for a PPO plan. An HMO doctor may be extremely busy, which can impact their level of care. Those who want more flexibility can spend a little more for a savings account plan or PPO. There's also a Point of Service option, which essentially combines an HMO and PPO. A person may need to spend more to see an out-of-network doctor, but at least they're allowed the freedom.

Healthcare plans can be exceptionally complicated, so it's important to talk it over with someone who understands the nuts and bolts. The contingencies and exceptions for different plans are nearly infinite, so individuals should never assume that something is covered (or even put towards their deductible). Asking questions and doing the homework can go a long way to narrowing down the right option.

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