The same plan, bought in the wrong place, costs you thousands

We get this question more often than you'd think: "I found the same plan for the same price directly from the insurance company — why bother with the exchange?"

It's a fair question, and the premise behind it is right. It's the conclusion that ends up costing people thousands of dollars a year.

The premium really is the same

If you buy a given plan through Connect for Health Colorado or straight from the carrier, the list price doesn't change, because carriers aren't allowed to undercut the exchange on an identical plan. So if somebody tells you they have a cheaper version of the same plan, what they have found is a different plan.

The help is not the same

Here's where it goes wrong. The financial help — the federal premium tax credit, the federal cost-sharing reductions that make Silver plans good value if your income is under 250% of the poverty level, and Colorado Premium Assistance on top of those — only exists on plans you buy through Connect for Health Colorado.

Buy the identical plan off-exchange and none of it reaches you. Same carrier, same doctors, same benefits, same list price, and you're paying every dollar of it yourself.

How people end up there by accident

Almost nobody chooses this on purpose. It usually happens one of three ways:

• You start on a carrier's own website, which sells both kinds and doesn't always make it obvious which one you're looking at
• You use a comparison site that mixes off-exchange quotes in with the on-exchange ones
• You work with an agent who's only appointed off-exchange, and it doesn't come up

None of that is necessarily anybody being dishonest. It's just that "is this on the exchange?" is the one question nobody thinks to ask, because the plan looks identical either way.

When off-exchange is genuinely fine

It isn't a trap in every case. If your household income is above the point where any help kicks in, you'd qualify for nothing wherever you bought, so where you buy makes no difference to what you pay. And every so often there's an off-exchange plan design that happens to suit somebody's situation better.

That's real, but it's a narrower set of circumstances than people assume — so it's worth confirming you're in it rather than taking it for granted.

The question to ask before you sign

Don't ask which price looks better today. Ask whether you'd qualify for help on either one, and whether the quote sitting in front of you has already taken that help into account.

And if you already have a plan and you're not sure how you bought it, tell us the carrier and we'll find out for you. It takes about two minutes, and every so often it turns out to be worth several thousand dollars a year.