Frequently Asked Questions
Learn more about Bright HealthCare and help us find the right plan for you.
We know Health Insurance can be confusing, but our mission is to make it easier for you. Check out our FAQs (frequently asked questions) and learn all about Bright HealthCare, our Individual & Family health insurance plans, the Affordable Care Act (ACA) Marketplace, Open Enrollment, Special Enrollment and much more.
How can I enroll in an Individual & Family plan?
The Open Enrollment Period for Individual & Family health insurance typically runs from November 1 to December 15. However, some states extend the period if they have their own exchange, like Colorado did last year. Plans sold during Open Enrollment start January 1.
If you or anyone in your household has had a “major life event” like the ones below within the last 60 days, you may qualify for a Special Enrollment Period which is offered throughout the year:
- Got married
- Had a baby, adopted a child, or placed a child for adoptive or foster care
- Got divorced or legally separated and lost health insurance
- Lost a job and your health insurance
- Death of someone on your plan
- Changes in residence that moves you out of your current network
- Loss of health insurance
Please know this is not a complete list of events that trigger Special Enrollment qualification. For more qualifying event information, visit .
Tell me about Bright HealthCare.
At Bright HealthCare, we’re on a mission to make healthcare right together. We approach healthcare plans, services and benefits with the goal of making them easy-to-use and easy-to-understand. We collaborate with curated network of providers that we call Care Partners – to make health care simpler, personal and more affordable. Learn more about Bright HealthCare.
Our Care Partners are curated healthcare networks of doctors, clinics and hospitals in your community – hand-selected by Bright HealthCare to help deliver simpler, more personal and affordable healthcare at the best possible price. They do this by bringing you:
- Better coordinated care
- Seamless healthcare experience from enrollment to doctor’s visits and billing
- Meaningful, useful benefits
- Lower cost of exceptional care
All things work better with great relationships, and having a local Care Partner in each community we serve allows us to make things run as smooth as possible. These partnerships mean we work together for one singular purpose—quality care for you, that’s easy to manage and the best possible value.
Consumer satisfaction statistics are available upon request.
Individual & Family Health Insurance 101
A primary care provider (PCP) is the main healthcare provider you see for routine care or common medical problems. Most often your doctor, the PCP, may also be a nurse practitioner or physician assistant.
A broker or agent can help you better understand your health insurance options and can help you save money. They are an excellent resource to use while shopping for healthcare, which we all know is a pain, to help you find the right care for the right price. Learn more about brokers here.
A healthcare network is a system of facilities (hospitals and clinics), providers (doctors), and suppliers (pharmacies) that your health insurance company has contracted with to provide healthcare services. Bright HealthCare works diligently to hand-select quality healthcare networks as our Care Partners.
In-network refers to providers or healthcare facilities that are part of Bright HealthCare’s network of providers with which we have negotiated service. When you see an in-network provider, your bills will likely be lower. An out-of-network provider is one that has not contracted with Bright HealthCare. If you see an out-of-network provider, your bills will likely be much higher except in cases of emergency or if we authorize you to receive care out-of-network. Learn how to better understand the possible financial impact of going out of network.
A copayment (or “copay”) is a monetary charge that your health insurance plan may require you to pay in order to receive a specific medical service or supply. For example, your health insurance plan may require a $15 copayment for an office visit or brand-name prescription drug.
The amount you pay for covered healthcare services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services.
The percentage of costs of a covered healthcare service you pay (20%, for example) after you've paid your deductible. Let's say your health insurance plan's allowed amount for an office visit is $100 and your coinsurance is 20%. If you've paid your deductible: You pay 20% of $100, or $20 – until you’ve reached your maximum out-of-pocket amount.
In the United States, an Exclusive Provider Organization (EPO) is a hybrid health insurance plan in which a primary care provider is strongly advised. Healthcare providers must be seen within a predetermined network. Out-of-network care generally is not provided except in cases of emergency or if we authorize you to receive care out-of-network. Bright HealthCare offers EPO plans on the Individual & Family health insurance exchanges.
Tell me about the Affordable Care Act and subsidies.
Plan costs will vary. You can view plans and get a quote online or call Bright HealthCare at 833-356-1182 and we can help you estimate your costs. You can save by checking to see if you qualify for Affordable Care Act (ACA), or Obamacare, government subsidies. Learn more about how subsidies work and how to get them.
The Affordable Care Act (ACA) is the comprehensive health care reform law enacted in March 2010, sometimes known as ACA, PPACA, or Obamacare. The law provides consumers with subsidies, or premium tax credits, that lower costs for many households who qualify based on income.
A navigator or certified assister is someone trained and paid by the federal government to help you navigate your Health Insurance Marketplace. They are unbiased and will try to get you government subsidies and help you find the best plan for the best price. Learn more about navigators.
The Health Insurance Marketplace, also known as the “Marketplace” or “exchange,” provides health plan shopping and enrollment services through websites, call centers, and in-person help. Some states, such as Colorado, run their own Marketplaces. They are kind of like Amazon, basically, a website that offers and sells all the plans, but doesn't make products itself. This is also the place where you get subsidies, or Advanced Premium Tax Credits (APTC).
The Advanced Premium Tax Credit (APTC) is a federal subsidy available to individuals and families who earn less than 400% of the Federal Poverty Level (FPL). This subsidy helps to pay part of your health insurance premiums in order to make your insurance more affordable as part of the Affordable Care Act (ACA).
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