Colorado Health Insurance Exchange Links
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Can You Get Medicare
Medicare is a government health program for seniors and people with disabilities. To get Medicare coverage, you or a family member must have worked for a certain number of years and met other eligibility rules.
If you get Medicare, you cannot get government help to pay for an individual health plan. You can still buy an individual plan through Connect for Health Colorado, but you have to pay the entire premium yourself. Note: If you get Medicare and want more coverage than it offers, look into Medicare Advantage or Medicare supplement policies. Connect for Health Colorado does not offer these.
If you cant get Medicare, individual coverage might be a good option for you.
Universal Healthcare Defeated In Colorado In 2016 Election
Supporters of universal healthcare in Colorado worked for months to gather signatures in support of ColoradoCare, a universal coverage system that would have gone into effect in 2019 if voters had approved it in the 2016 election. But voters resoundingly rejected the measure, with just 21 percent in favor, and 79 percent opposed.
ColoradoCare would have been enacted using a 1332 waiver under the ACA, which allows states to chart their own course for healthcare reform, as long as they do so in a way that covers at least as many people as the ACA would have, keeps coverage affordable and at least as comprehensive as it would be under the ACA, and doesnt increase the federal deficit.
If those general guidelines are satisfied, the state can receive funding from the federal government equal to what would have been provided to the states residents in premium tax credits, cost-sharing subsidies, and small business tax credits. In Colorado, those funds, together with Medicaid waiver funds, were projected to total $11.6 billion in 2019. Total costs to run a zero-deductible, universal coverage program in Colorado were estimated at $35.6 billion for 2019. The $25 billion difference would have been generated through a 10% income tax. Employees would have paid only a third of the total tax, with their employers kicking in the remaining two-thirds .
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See If You Can Sign Up For Child Health Plan Plus
Who Qualifies?
- Children age 18 and under and pregnant women age 19 and over
- Applicants with household income under 260% of the Federal Poverty Level . See the CHP+ Income Chart for details
- Lawfully present children and pregnant women with no five-year waiting period
- Children and pregnant people not eligible for Health First Colorado
- Children and pregnant people who do not have other health insurance
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See If You Can Sign Up For Health First Colorado
You may qualify for Health First Colorado if you meet the monthly income guidelines:
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Can I still sign up for a plan through Connect for Health Colorado if I qualify for Health First Colorado?
- Yes. You can still purchase a private health insurance plan at full price if you qualify for Health First Colorado.
- NOTE: If you qualify for Health First Colorado or CHP+, you will not qualify for financial help to lower the cost of your health insurance plan through Connect for Health Colorado. You will pay full price for your health insurance plan.
I applied through Connect for Health Colorado and was told that my application was sent to Health First Colorado. Whats next?
- Watch your mail or email. You will get a notification from the State of Colorado with your application results. You will also receive a letter or email if more information is needed to complete the process.
- You may also check the results of your application through your PEAK account.
- If you do not have a PEAK account, you can create one at Colorado.gov/PEAK.
- You can use your Connect for Health Colorado log-in and password information to sign into PEAK.
- You can also use PEAK to manage your Health First Colorado or CHP+ benefits, print benefit cards, report changes and more.
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What Health Insurance Companies Offer Coverage In Colorado’s Exchange
Eight insurers offer coverage in Colorados exchange in 2021, and all will continue to do so for 2022: Anthem , Bright, Cigna, Denver Health, Friday Health Plan, Kaiser Permanente, Oscar, and Rocky Mountain Health Plan. Two insurers expanded their coverage areas for 2021, and four are doing so for 2022. So while there were 22 counties in Colorado where Anthem BCBS was the only insurer offering plans in the exchange in 2020, that dropped to ten counties in 2021, and will drop to just one county for 2022.
Colorado has always had a robust exchange, although most of the insurer participation is concentrated along the I-25 corridor . In the mountains and eastern plains, insurer participation has been much more limited. In the first few years of exchange operation, there was some upheaval in terms of insurer participation, but it had leveled out at seven insurers. Oscar Health joined the Colorado exchange in the Denver metro area in 2020, bringing the total number of insurers to eight.
Heres a look at how carrier participation in Colorados exchange has changed over time:
2014: Ten insurers offered individual market plans in Colorados exchange in 2014: All Savers, Cigna, Colorado Choice, Colorado Health OP , Denver Health, HMO Colorado , Humana, Kaiser, New Health Ventures , and Rocky Mountain Health Plans.
2015: The same ten insurers continued to offer individual market plans in the exchange in 2015.
Doi Banned Differing Commission Structures For Brokers
In late 2015, many of the nations health insurance carriers began reducing or eliminating broker commissions, mostly for plans sold outside of open enrollment or for benefit-rich plans at the gold and/or platinum level.
The general consensus was that the commission cuts were an effort by health insurance carriers to limit sales in general, or to limit sales of benefit-rich plans, which tend to be more popular among enrollees who have health conditions, and are more expensive to insure. In 2014 and 2015, eligibility for special enrollment periods was very loosely enforced by Healthcare.gov and some of the state-run exchanges, and carriers noted that healthcare utilization tended to be higher for people who enrolled outside of open enrollment.
In December 2015, Colorados Department of Insurance issued a regulatory bulletin stating that carriers cannot offer differing commission structures, which they defined as different commission levels for different metal levels, different commission structures for plans sold during open enrollment versus outside of open enrollment, or not paying commissions on certain plans offered in the State of Colorado. The Department of Insurance warned carriers that none of those actions are allowed, and that carriers that utilize differing commission structures would risk enforcement actions to remedy those violations.
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State Is Seeking Cms Input On Whether Federal Permission Could Be Granted To Allow Anyone To Buy A Catastrophic Plan
S.B.132 was signed into law in 2018, and directed the state to conduct an actuarial study on the impact of allowing people over the age of 30 who dont have hardship exemptions to purchase catastrophic plans. The bill was amended in February 2018 to ensure that the catastrophic plans would only be available through the exchange. The provision requiring that the state conduct an actuarial study and only submit the 1332 waiver if the proposal would not reduce total premium subsidies or increase average premiums was also an amendment .
The ACAs premium subsidies cannot be used for catastrophic plans, so the expansion of catastrophic plans would likely only appeal to healthy people who arent eligible for subsidies and are currently paying full price for the cheapest bronze plans they can get . The legislation stated that if the study found that doing so would not reduce the total amount of premium subsidies provided to Colorado residents, and would not result in higher average individual market premiums, the state would then submit a 1332 waiver to the federal government, seeking permission to allow anyone in Colorado to purchase a catastrophic plan .
Information about S.B.132, the actuarial study, and correspondence with CMS can be found here.
Can You Get Health First Colorado
Health First Colorado is a government health program for people with low income. Its a great program that usually has no monthly premium and copayments for services that are usually much lower than copayments required by individual plans. Also, Health First Colorado may cover some services that an individual plan doesn’t cover.
If you cant get Health First Colorado , individual coverage might be a good option for you.
You may qualify for Health First Colorado if you are in one of these situations:
- Your familys income is at or below 138% of the Federal Poverty Guidelines . The income limits are higher if you are 18 or younger or are pregnant. There are no limits to how much money or other resources you have. Learn more about income-based Health First Colorado .
- You have a disability or are elderly:
- Health First Colorado for people with disabilities and seniors may offer additional services, but has more eligibility requirements, such as having a disability, having low resources, and different income rules. benefits, you qualify automatically.) Learn more about disability-based Health First Colorado .
- The Health First Colorado Buy-In Program For Working Adults With Disabilities lets people with disabilities who make more money than the income limits for other types of Health First Colorado get coverage. However, you may have to pay a monthly premium. Learn more about the Medicaid Adult Buy-In.
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Applying For Cost Saving Programs Determining Your Monthly Premium & Getting Covered
Connect for Health Colorado is Colorados health insurance exchange and it is the only place you can get an Advance Premium Tax Credit to reduce the cost of your health insurance. However, you can still get health insurance through the exchange, even if you dont qualify for or want to apply for the Advance Premium Tax Credit.
First, go to Connect for Health Colorado and Create an Account or Login if you already have an account.
Next, authorize me as your Agent at Connect for Health Colorado. This only takes seconds and is required before I can help you with your new insurance plan, answer questions and service your account going forward. There is no charge or extra cost for my services. I am paid a small commission by the insurance companies which helps us keep the lights on and provide resources like this to serve the community.
Mountain Valley Developmental Services
Mountain Valley Developmental Services supports adults and children in Eagle, Garfield, Lake, and Pitkin counties with intellectual and developmental disabilities . Our work provides life span services for these individuals, their parents and family members, guardians, colleagues at work, neighbors, and friends to promote independence, quality of life, and rights protection.
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What If I Want To Explore My Options
If you lose your health coverage in the future or are unhappy with your current coverage, visit our I Need Health Insurance page to learn about other health coverage options available to you.
Also, youre free to buy health insurance from a private company or broker anytime. All plans have been reviewed by the Colorado Division of Insurance to make sure they meet the requirements for health care reform.
Eligibility For Advance Premium Tax Credits
First, use the chart below to see if you may be eligible for Health First Colorado or CHP+. These numbers are estimates, as charts for 2022 are not yet available, as of November 1st, 2021. Please note that the income ceilings for federal tax credits are removed for 2021 and 2022, due to the American Rescue Plan law. So, If your familys monthly gross income is above the levels in the first column then you may be eligible for federal tax credits. Please request a quote, so we can verify if youre tax credit eligible.
Advance Premium Tax Credits are available to people with household Modified Adjusted Gross Income between 138% and 400% of federal poverty level. Tip: You can estimate your tax credit with the Subsidy Calculator tool. Take note that the higher your income, the lower your tax credit will be.
If your monthly income is below 138%, you should be eligible for Health First Colorado . Advance Premium Tax Credits are not available to people eligible for Health First Colorado or Medicare or who have affordable coverage through an employer.
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Getting Marketplace Coverage In Colorado: Step By Step
Open enrollment re-opened on November 1st for plans with a January 1st, 2022 start date. It is scheduled to close in Colorado on January 15th, 2022.
After open enrollment closes, people who buy their own health insurance can only shop for a new plan or change their existing plan if they have a qualifying event. Please note that you can apply up to 60 days before the qualifying event and no more than 60 days after the qualifying event , so timing is everything. Let us help you evaluate your plan options available both on and off the Connect for Health Colorado Marketplace.
Health First Colorado This Program Is For Families And Individuals Health First Colorado Is Available To Pregnant Women Children Under The Age Of 18 Adults Over The Age Of 60 Or Permanently And Totally Disabled And Working Adults With Disabilities Between The Ages Of 16 And 64 And Adults Without Dependent Children Between The Ages Of 19 And 64 Only Us Citizens And Legal Resident Aliens Are Eligible For Regular Health First Colorado Pregnant Undocumented Women Are Eligible For Delivery Costs Only
For pregnant women and children, applications are available in English and Spanish. For adults over the age of 60 or permanently and totally disabled applications are available in English and Spanish .
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Non-Emergency Medical Transportation – Health First Colorado , in addition to providing medical coverage for more than 1 million Colorado residents, is free transportation to and from your doctors appointments or can help eligible customers pay for their travel expenses incurred for non-emergency travel to and from doctor appointments and other health-related appointments.
If you are eligible for Health First Colorado and anticipate needing a ride to a doctors appointment, please contact Valley Taxi at 404-5181 or High Mountain Taxi at 925-8294 for assistance.
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Can You Get Employer
Many employers offer private health coverage as a job benefit for employees, their children until they turn 26, and their spouses. If your employer, your parents employer, or your spouses employer offers you health coverage that would cost the employee, for the employees policy alone, less than 9.5% of your familys income and that coverage meets bronze-level standards, neither you nor your family will qualify for government help paying for an individual plan. If you can get employer-sponsored coverage, but sign up for an individual plan anyway, you will have to pay the full premium.
Note: It might be expensive for you to sign up for an employer-sponsored plan, if you are not the employee. Even so, you would not be able to get government help to pay for individual health coverage.
If you cant get employer-sponsored coverage, individual coverage might be a good option for you.
So What Does All This Mean To Coloradans
Since you already have employer-provided health insurance, privately purchased insurance, Health First Colorado , Child Health Plan Plus, Medicare, or military coverage you probably wont need to do anything. Most of the changes have to do with expanding health care coverage to Americans who are uninsured.
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When Is Telemedicine A Good Option
Telemedicine is best for members who need help from a provider who is located far away from the member, and for members with transportation difficulties. Telemedicine should not take the place of seeing a provider in person when medically necessary.
Contact your provider to learn more about how to use telemedicine.
If you are a provider, please see our Telemedicine – Provider Information page.
What Type Of Health Insurance Exchange Does Colorado Have
Colorado has a state-run exchange, Connect for Health Colorado. The state passed legislation in 2011 to create the exchange, and is among 18 states that are running their own exchanges and enrollment platforms for 2022 coverage.
Although some carriers exited the Colorado exchange at the end of 2016 as was the case in most states Connect for Health Colorado is still among the most robust exchanges in the country, with eight carriers offering plans for 2021 and 2022. In the individual/family market, there are 257 on-exchange plans available in Colorado for 2022, up from 159 in 2021 and just 130 in 2020 .
- 2021: 179,607 people enrolled.
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