Reviewed for accuracy on November 1, 2026 by Tina Price, one of Grove's licensed advisors.
Where people lose money on health insurance, and how to check
Most money is lost before the plan starts: an income guess, a network nobody checked, or a premium chosen without looking at the bad-year cost.
Last updated November 1, 2026
The short version
- Estimate your income carefully. From tax year 2026, going over 400% of the poverty level means repaying all of the credit.
- Check your doctors and hospitals in the network of the exact plan, not just the company.
- Compare the bad-year cost: twelve months of premiums plus the out-of-pocket maximum.
- Pick a plan by December 15 for coverage on January 1.
1. Guessing your income too low
Your tax credit is based on the income you expect for the year. At tax time, the IRS compares it with what you earned.
Starting with tax year 2026, the caps on repayment are gone. If your income ends up above 400% of the federal poverty level, you repay all of the credit you used. For a household near the line, that can be thousands of dollars.
What to do: estimate from your most recent pay and any expected changes. If your income changes during the year, update your application with Connect for Health Colorado.
2. Assuming your doctor takes every plan from an insurance company
A network is the doctors, hospitals, and suppliers a plan has agreements with. One insurance company can sell plans with different networks, so your doctor may take one of its plans and not another.
What to do: look up each doctor and hospital in the directory for the exact plan. Then call the office and ask whether they are in network for that plan name.
3. Choosing on the monthly price alone
A low premium usually comes with a high deductible: what you pay for covered care before the plan starts paying. In a bad year, you pay more before the plan steps in.
What to do: for each plan, add twelve months of premiums to the out-of-pocket maximum. That maximum is the most you pay for covered in-network care in a year. The total is your bad-year cost.
4. Not checking your prescriptions
Each plan has its own drug list, called a formulary. A medicine can be covered by one plan, on a higher tier in another, or need approval first.
What to do: look up each medicine on the plan's drug list before you enroll. If one isn't covered, ask your doctor about alternatives.
5. Missing a deadline
Open enrollment for 2027 runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 and coverage starts January 1. Pick one by January 15 and it starts February 1.
Losing job coverage usually opens a special enrollment period. It runs 60 days before and 60 days after the date coverage ends.
What to do: finish by December 15 even if you have coverage through December. It leaves time to fix a mistake.
6. Paying for children who qualify for CHP+
CHP+ covers children and pregnant people with household income up to 260% of the federal poverty level who don't qualify for Health First Colorado (Medicaid). You can apply any time of year.
What to do: if your income is near that line, apply through Colorado PEAK before you buy a plan for your children.
7. Skipping the enhanced silver plans
If your income is up to 250% of the federal poverty level, enhanced silver plans can lower your deductible and copays. A bronze plan can look cheaper and cost more once you need care.
What to do: if you qualify, compare the enhanced silver plans with bronze on the bad-year cost.
8. Letting last year's plan renew without a look
Connect for Health Colorado usually renews your plan automatically. The price, your financial help, and the doctors in the plan's network can all change.
What to do: price your household again each fall and check your doctors and medicines against the renewed plan.
Next step
A licensed Grove advisor checks these with you before you enroll, at no cost. Insurance companies pay us, and your premium is the same either way.
Want a person to check your pick? A licensed Grove advisor will, at no cost. If you make Grove your broker, you can keep calling the same advisor after you enroll.
Compare plansPrices in your countyCall (970) 840-1130
Common questions
What is the most expensive mistake?
For households near 400% of the poverty level, an income guess that turns out low can mean repaying the whole tax credit. For everyone else, it is usually a doctor or hospital outside the plan's network.
Can I change plans after I enroll?
During open enrollment, yes. After January 15, you generally need a qualifying life event, such as losing other coverage, marriage, or a new baby.
Sources
- HealthCare.gov glossary: premium tax credit
- HealthCare.gov glossary: network
- HealthCare.gov glossary: formulary
- HealthCare.gov glossary: deductible
- HealthCare.gov glossary: out-of-pocket maximum
- HealthCare.gov: special enrollment periods
- Colorado HCPF: Child Health Plan Plus (CHP+)
- Colorado PEAK: apply for Health First Colorado and CHP+
- Connect for Health Colorado: early look at 2027 plans and prices
- Connect for Health Colorado: get financial help
This guide is general information, not tax or legal advice. Connect for Health Colorado decides eligibility and tax credits.