Colorado Health Insurance

Overview

If you live in Colorado and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:

  • Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
  • Compare private health plans using U.S. News & World Report's health insurance ratings for Colorado

Do I Qualify for a Tax Break on Health Insurance?

Use the calculator below to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.

What Plan Type is Right For Me?
How Many Need Coverage
Total Annual Income
 
 

You may qualify for Medicaid, a free, state-sponsored health insurance program. Call 855-752-6749 or go to the Connect for Health Colorado website to find out if you can enroll in Medicaid.

You qualify for a subsidy (tax credit) that will save you money if you buy a plan on Colorado's new insurance marketplace, called Connect for Health Colorado. Plans should be offered there starting October 1, 2013. While your subsidy will cover part of the monthly premium for any of the marketplace's plans, a plan that's in the "silver tier" probably offers the best deal. That's because you also qualify for a second subsidy that increases the value of benefits you'd get from any silver plan.

You qualify for a subsidy (tax credit) that will save you money if you buy a health plan on Colorado's new insurance marketplace, called Connect for Health Colorado. Plans should be offered there starting October 1, 2013. Your subsidy will cover part of the monthly premium for any of the marketplace's plans, known as Qualified Health Plans.

You don't qualify for a subsidy. You can either buy a plan on the Connect for Health Colorado website or click the button below to compare U.S. News-rated plans in your state's private insurance market. Plans on Connect for Health Colorado will generally offer more health coverage than plans in the private market, but they also tend to cost more in monthly premiums. The Connect for Health Colorado website should offer plans beginning October 1, 2013.

Any children in your household may be eligible for Medicaid. Call 855-752-6749 or go to the Connect for Health Colorado website to find out if your children are Medicaid-eligible.

See Plans

If You Qualify: Plans That Cost Less

Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Colorado. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage. 

Note: you had until March 31 to enroll for coverage for the rest of 2014 (enrolling on March 31 would cover you starting May 1). If you missed this date, with few exceptions, you will pay a penalty.

If You Don't Qualify: Private Plans

If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Colorado’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage.  What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.

Do I Have To Buy Health Insurance?

You may have heard that everyone in Colorado must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per adult plus $47.50 per child (up to $285 per family) or 1 percent of your family’s income, whichever is more. 

U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.

Where To Buy Health Insurance

Colorado's Official Marketplace

Connect for Health Colorado is Colorado’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Connect for Health Colorado, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:

  • Social security numbers for everyone in your household
  • Your employer’s name and address
  • Your most-recent pay stub or recent records of your wages
  • Information about other types of income you receive, such as alimony, unemployment benefits or a pension

 

Insurance Companies and Brokers

Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Connect for Health Colorado website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.

U.S. News & World Report has teamed up with eHealth.com, an online broker licensed to sell health insurance, to help you buy the health plan you want. The eHealth customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.

Qualified Plans on Connect for Health Colorado

Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.

You should also look at a Connect for Health Colorado plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Connect for Health Colorado plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"

Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.

Participating Companies

All Savers Insurance Company. All Savers is a part of United Healthcare Company, a division of United Health Group, the largest U.S. insurance company with over 70 million members. Its national network includes over 726,500 doctors and 5,600 hospitals. All Savers offers nine exchange plans in Colorado.

Cigna Health and Life Insurance Company. Formed in 1982, the global health service company serves 75 million members worldwide. Colorado residents who buy a Cigna exchange plan have access to the entire network, however, the plans are more expensive than competitors for that reason, according to the Denver Business Journal. Cigna’s local network is Denver LocalPlus.

Colorado Choice Health Plans (CCHP). Established in 1972 to provide health insurance to residents living in the San Luis Valley, the nonprofit now offers coverage in more than thirty counties.

Colorado HealthOP. This new, nonprofit, member-governed, co-op is the first of its kind in Colorado. Sponsored by the Rocky Mountain Farmers Union (RMFU) Educational and Charitable Foundation, Colorado HealthOP offers statewide coverage through the Cigna and Cofinity Rental networks, according to the company. The PPO network is available statewide, but the EPO network is limited to the following counties: Arapahoe, Boulder, Broomfield, Clear Creek, Denver, Douglas, Gilpin, Grand, Jefferson, La Plata, Larimer, Logan, Morgan, Park, Summit and Weld. Colorado HealthOP covers health services for transgender residents, reports The Denver Post. Colorado HealthOP offers two plans on the exchange through the following two networks: CoOpCentralMetro and CoOpStateWideOne.

Denver Health Medical Plan, Inc. Established in 1997, this health maintenance organization (HMO) is an entity of the Denver Health and Hospital Authority (DHHA) and serves more than 15,000 Denver residents. DHMP offers four exchange plans.

HMO Colorado Inc. (Anthem Blue Cross and Blue Shield). As an open access health maintenance organization (HMO), members do not need to get referrals to see specialists. Colorado residents who buy an Anthem exchange plan may not have access to the entire network of doctors and hospitals. Its physician network has been reduced by 40 percent compared with plans sold off the exchange, reports the Denver Business Journal. Anthem offers fourteen exchange plans. 

Humana Health Plan & Humana Insurance Company. Established in 1974 in Louisville, Ky., Humana is one of the largest U.S. health insurance companies with over 11.5 million members.

Kaiser Foundation Health Plan of Colorado. Established in 1945, the Kaiser Foundation Health Plan of Colorado is a subsidiary of Kaiser Permanente, one of the largest nonprofit health insurance companies in the U.S. with over 540,400 members in the following counties: Denver, Colorado Springs, Boulder and Pueblo. Its network includes 17,157 doctors and 37 hospitals. Kaiser also covers health services for transgender residents, reports The Denver Post. Kaiser offers twenty-seven exchange plans through the following three networks: KP DenverBoulder, Northern Colorado and Southern Colorado.

Access Health Colorado (New Health Ventures). Established in 1994, this nonprofit company is sponsored by Children’s Hospital Colorado, Colorado Community Managed Care Network and the University of Colorado/University Physicians, Inc. Access Health offers six exchange plans.

Rocky Mountain HMO. For over 35 years, this independent, nonprofit health insurance company is the only insurer to serve every market including employers, individuals, Medicare, Medicaid, and Child Health Plan Plus (CHP+) beneficiaries, according to the company. Rocky Mountain HMO offers eighteen exchange plans through the following four networks: Rocky Mountain HMO Colorado Springs Health Partners Provider Network, Rocky Mountain HMO Mesa County Provider Network, Rocky Mountain HMO New West Provider Network, Rocky Mountain HMO Statewide Provider Network.

Need More Help?

If you need help choosing a health insurance plan or filling out your application, Colorado has trained nongovernment groups to guide you through the process. Sometimes called “Navigators,” these groups can answer technical questions on insurance, Medicaid, and tax credits (subsidies on monthly premiums) . Navigators also specialize in assisting non-English speaking populations. For more information, contact the Connect for Health Colorado call center at 855-752-6749. The center is open Monday through Saturday from 7:00 a.m. to 8:00 p.m.

The Colorado Division of Insurance exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 303-894-7490 or emailed at insurance@dora.state.co.us. Residents can file an insurance complaint online.

Health Insurance Guide

U.S. News offers information on how to buy health insurance and publishes plan ratings for every state. If you’re over 65, see the guide to Medicare plans. Otherwise, start by looking up the Health Insurance Guide for your state.

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2014-05-01