En español | Most Coloradans are eligible to buy health insurance through Connect for Health Colorado, the state’s Affordable Care Act (ACA) marketplace. And you might be able to save money on premiums, thanks to expanded federal tax credits in the March coronavirus relief bill. In fact, Coloradans can save an average of 49 percent on monthly premiums. Connect for Health Colorado's open enrollment period begins on Nov. 1 and runs through Jan. 15, in line with the federal Healthcare.gov marketplace. But you may still be able to switch to a marketplace plan if you get married, have a baby or experience another qualifying life event.
Most people already enrolled in ACA marketplace plans will also see their premiums go down this year because the recently enacted American Rescue Plan increases tax credits for insurance premiums and expands the number of households who qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help it afford health insurance. Prior to the new law, such tax credits were available only to people making up to 400 percent of the federal poverty level (around $51,000 for one person).
The average American with a marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will only be available in 2021 and 2022.
Who is eligible?
- Colorado residents, including legal immigrants, are eligible to buy insurance through Connect for Health Colorado. More information about who can enroll is on Connect for Health Colorado’s website.
- You may also qualify for Health First Colorado, the state’s Medicaid plan, which offers health care coverage with no monthly premium to low-income people and families. There’s also Child Health Plan Plus (CHP+), low-cost public health insurance for certain children and pregnant women. When you apply for an insurance plan through Connect for Health Colorado, you'll learn if you might qualify for one of these free or low-cost options, which are described on the marketplace website.
When can I enroll?
- Connect for Health Colorado open enrollment runs from Nov. 1 through Jan. 15.
- You can enroll anytime if you experience a qualifying life event, but in most situations you only have 60 days from that event to enroll. Qualifying events include certain moves, births and adoptions, loss of employer-provided coverage, marriage, divorce and other special circumstances.
- Year-round enrollment is open to Coloradans who qualify for Health First Colorado or CHP+ and to members of federally recognized Native American tribes.
How do I sign up?
You apply for coverage and choose your plan at the same time. As soon as you submit an application with Connect for Health Colorado, you'll learn what coverage you're eligible for. If you qualify for private coverage, you can shop for plans and continue the enrollment process immediately. If you're eligible for a public plan, such as Health First Colorado or CHP+, you’ll receive an email or letter from the state with information about next steps.
If you enroll in a private plan, your coverage will not begin until you’ve paid your first monthly premium.
To apply and enroll:
- Online: Go to Connect for Health Colorado’s website to apply and enroll. You can ask general questions through a live chat option during business hours. Connect for Health Colorado’s website lists lots of ways to find help and learn more about plans and financial assistance.
- By phone: Call Connect for Health Colorado’s customer service center for enrollment and application assistance at the toll-free number 855-752-6749 (if calling inside the United States only) or 303-590-9675. If you’re hearing-impaired, call the TTY line at 855-346-3432. Representatives are available between 8 a.m. and 6 p.m. MT, Monday through Friday.
- In person: Contact an enrollment center near you to set up a virtual or in-person appointment with a certified insurance broker or enrollment assister. Or attend an enrollment event in your area.
What is covered, and how much will it cost?
Coverage and cost depend on where you live, the type of plan you choose, your household income, the size of your family and the age of you and your family members.
If you qualify for Health First Colorado coverage or CHP+, you will be able to get free or low-cost insurance and may not need to worry about premiums or copays.
All Connect for Health Colorado plans cover essential health benefits, including:
- Emergency services and hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services (including counseling)
- Outpatient hospital care
- Pediatric services, including dental and vision
- Prescription drugs
- Preventative care
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
All Connect for Health Colorado coverage plans include basic dental and vision services for children, but adults who want dental and vision insurance must add these plans to their policy. Deductibles and out-of-pocket costs vary between plans.
What about new federal assistance for premiums?
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income now qualifies for federal tax credits for insurance premiums.
For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.
Is there any other financial assistance available?
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles, prescriptions and copays. You must enroll in a Silver-level plan to get this assistance.
If you received unemployment benefits in 2021, even for just one week, you may qualify for an almost $0/month premium health coverage option through Connect for Health Colorado, thanks to new savings offered through the American Rescue Plan. You can sign up for a $0/month plan during this current enrollment period. If, however, you're already enrolled in a marketplace plan, you can update your application to apply this additional subsidy moving forward. You'll also be able to claim the additional subsidies for the months during which you were eligible when you file your 2021 federal income tax return. This extra financial help will expire at the end of 2021.
What plans are available?
Most Connect for Health Colorado plans are organized into three categories:
- Bronze plans have the lowest monthly premiums, the highest deductibles and copays, and cover roughly 60 percent of care costs. These plans are designed for those who are healthy and rarely go to the doctor.
- Silver plans have moderate monthly premiums, deductibles and copays. They cover about 70 percent of care costs and potentially much more, if you come from a lower-income household and qualify for cost-sharing reductions — a subsidy only available through silver plans.
- Gold plans have higher monthly premiums, lower deductibles and copays, and cover roughly 80 percent of care costs. These plans are intended for those with medical conditions that require ongoing attention.
Coloradans under 30 can also apply for a catastrophic health plan that offers a low monthly premium, a very high deductible and exists to protect customers in worst-case scenarios.
Connect for Health Colorado’s Quick Cost & Plan Finder tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance. The site also offers tips for choosing the plan that’s right for you.
What if I already have health insurance?
If you already have affordable coverage — through your employer, your spouse’s employer or Health First Colorado (Medicaid), for example — you will not qualify for financial help offered through the marketplace plans. More information about who’s ineligible for Connect for Health Colorado coverage is on the marketplace’s website.
If you’re independently enrolled in a private health insurance plan, not through an employer, you may qualify for significant savings if you switch to a Connect for Health Colorado plan. But you may need to wait until open enrollment.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) because you were terminated from a job or were put on reduced hours before Oct. 1, you may be able to save money by switching to a Connect for Health Colorado plan during a 60-day special enrollment window. Be sure to apply and select your plan through Connect for Health Colorado before your COBRA coverage ends to make sure there’s no gap in coverage. If you're not sure whether making this switch makes sense for you, you can ask for free advice from a certified insurance broker.
If you already have a marketplace plan and want to adjust your coverage, you'll need to wait until the open enrollment period begins this fall. If you don't take action, you'll be automatically reenrolled in your existing plan. But since plans and prices change every year, you should review your coverage and options to best meet your needs and budget.
Will I need to get a new doctor?
That depends. Connect for Health Colorado offers plans from a variety of insurance providers – including Anthem Blue Cross Blue Shield, Bright Health, Cigna, Denver Health, Rocky Mountain Health Plans/UnitedHealthcare and others. However, insurance companies may have different networks of doctors or providers for different plans, so before you select a plan, you may want to check its provider network to see if your doctor is included. You can also contact the insurance company to learn more about in-network versus out-of-network providers and what that means for you and your costs.
Connect for Health Colorado’s quick cost & plan finder tool shows you which medical providers or facilities accept which plans.
Will my family members qualify for the same health plan that I do?
It depends. Some family members may qualify for subsidies to enroll in a private health insurance plan while other family members qualify for public plans like Health First Colorado (Medicaid) or CHP+. Family members in the same household may qualify for different programs because of their age, income, disability, or caregiver status or immigration status. Such families may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted or whether their provider accepts Medicaid coverage.
If you're not sure what makes the most sense for your family, get free advice from a certified insurance broker.
This guide, originally published on June 23, was updated on Oct. 1 to include information about open enrollment and COBRA.