With its gorgeous mountain scenery and world-class skiing facilities, Colorado is a popular place to live.
More than half of Colorado residents get their health insurance through their employers. Eight percent of the population is uninsured, which is close to the national average.1
If you’re one of the millions who are uninsured, here’s what you need to know about your options.
Health insurance options in Colorado
Colorado health insurance costs will decrease in 2020. In October 2019, the state announced that rates would fall by an average of 20% in 2020.2 For many, the rate reductions were significant. And, if you qualify for subsidies, your premiums can be even lower, making insurance more affordable.
In January 2014, Colorado expanded Medicaid coverage through the Affordable Care Act, including more adults and former foster children up to the age of 26. Thanks to the expansion, more than 400,000 Coloradans were covered.3
In Colorado, your healthcare coverage options are dependent on your age, employment status, and income.
One thing to note is that short-term insurance plans are not an option in Colorado. Recent regulations affected short-term policies, causing insurers to cease operations in the state.4
Individual health insurance options under the Affordable Care Act
If you’re ineligible for insurance through an employer, you can get health insurance through Connect for Health Colorado — Colorado’s version of healthcare.gov.5 Bronze, Silver, and Platinum health plans offer cover preventative service including doctor visits, hospitalizations, and mental health care.
You can only sign up for health insurance through Connect for Health Colorado during the Open Enrollment Period, which lasts from November 1 through December 15. If you miss enrollment, you may be able to sign up for a plan if you qualify for a Special Enrollment Period. For example, if you lose your job, get married, or have a baby, you can apply for a plan outside of the Open Enrollment window.6
Colorado re-opened enrollment for residents due to the coronavirus pandemic. Residents qualify if they don’t have insurance, recently lost it or will soon lose their coverage. Sign ups end on April 30.
You can shop online and compare plans at connectforhealthco.com.
Companies who offer health insurance
In 2020, eight companies offered individual insurance on while one company had an off-exchange option.
The companies are:
- Anthem (HMO Colorado, Inc.)
- Anthem (Rocky Mountain Hospital and Medical Service, Inc., off exchange only)
- Bright Health Insurance Company
- Cigna Health and Life Insurance Company
- Denver Health Medical Plan, Inc.
- Friday Health Plans
- Kaiser Foundation Health Plan of Colorado
- Oscar Health Plan
- Rocky Mountain Health Maintenance Organization, Inc.
Health insurance costs
Health insurance costs dropped in 2020. The cost of the lowest-level silver plan cost $353 per month in 2020, on average — that’s down from $475 per month in 2019.7
Average Marketplace Premiums by Metal Tier
In Colorado, the average premiums for each tier for 2018 to 2020 are as follows:8
|Average Lowest-Cost Bronze Premium||Average Lowest-Cost Silver Premium||Average Lowest-Cost Gold Premium|
If you don’t make much money, you may consider applying for an insurance policy through Connect for Health Colorado. Low-income individuals can qualify for subsidies that make insurance more affordable. Over 155,000 Coloradans received healthcare subsidies in 2019 alone.9
If you’re self-employed
If you’re self-employed, your best option is to sign up for an insurance plan through Connect for Health Colorado. You can qualify for a policy even if you have a preexisting condition, and you may be eligible for a subsidy that reduces the cost of your premiums.
If you’re unemployed
If you leave your job or are laid off, you have two main options for health insurance:
You can maintain your previous employer’s health insurance policy through the Consolidated Omnibus Reconciliation Act (COBRA). With COBRA, you can keep your coverage for up to 18 months, giving you plenty of time to find a job and other insurance options. However, you’re responsible for 100% of the plan’s premiums, which can be costly.12
If you’re low-income
If you are struggling to make ends meet, health insurance may seem like an unaffordable luxury. But skipping coverage can be a costly mistake. According to the Colorado Health Institute, 18.1% of Coloradans struggled to pay medical bills, and over 30% faced an unexpected medical bill in the past year.13
There are a few options available to give you health insurance coverage at a lower cost:
Government-funded health insurance
Low-income residents in Colorado may qualify for the following programs:
1. Health First Colorado
Health First Colorado is Colorado’s Medicaid program. Eligible people can qualify for free or low-cost coverage and get preventative care, dental care, emergency services and transportation, prescription coverage, and more.
Over 1.1 million people in Colorado are enrolled in Medicaid.14
You may qualify for Health First Colorado if you’re a parent or an adult without dependent children with a household income that doesn’t exceed 133% of the Federal Poverty Line (FPL).15 As of 2020, your income must be below:
|Family Size||133% of the Poverty Guideline13|
2. Child Health Plan+
The Child Health Plan Plus is a low-cost health program for some children and pregnant women. If you make too much to qualify for Health First Colorado, but can’t afford private health insurance, Child Health Plan Plus can be a useful alternative.
To be eligible, you must meet the following criteria:16
- You must be a child under 18 or a pregnant woman age 19 or over
- Your income can’t exceed 260% of the FPL
- You must be lawfully residing within the state
- You must not qualify for other health insurance
As of November 2019, 78,338 residents had enrolled in Colorado’s CHIP.17
As of 2018, almost 900,000 Colorado residents enrolled in Medicare. About two thirds signed up for Original Medicare while the remaining third chose Medicare Advantage.18
While Medicare is usually for older people, you may qualify for Medicare if you have been entitled to Social Security or Railroad Retirement Board disability benefits for the past 24 months. Or, you have Lou Gehrig’s disease or are a kidney dialysis or kidney transplant patient.
Almost nine in 10 residents qualified for Medicare because they turned 65; the rest were eligible because they had a disability.19
With Medicare, hospital care lab tests, surgeries, and prescription drug coverage is provided.20
Once you’re 65 or older, you’re eligible for Medicare. If you or your spouse worked and paid Medicare taxes for 10 years or more, you’re eligible for premium-free Medicare Part A. In other words, you can enjoy health insurance without worrying about expensive monthly premiums.
If you don’t meet the criteria for premium-free Medicare Part A, you may be able to buy into the system. Use the Medicare Eligibility Calculator to see if you qualify for Medicare and to estimate what your premiums would be.21
There are different terms regarding Medicare you should know:
- Medicare Part A: Medicare Part A covers inpatient care in a hospital, skilled care in a nursing care facility, hospice care, and home health care.
- Medicare Part B: Medicare Part B covers medically necessary services and preventative services, including ambulance services, mental health inpatient or outpatient care, and medical equipment.
- Medicare Advantage Plans: Medicare Advantage Plans — sometimes referred to as Medicare Part C — are offered by private companies approved by Medicare. Medicare Advantage Plans provide all of your Part A and Part B coverage and may provide additional benefits like vision, dental, and health and wellness coverage.
- Medicare Part D: Medicare Part D is an optional benefit you can add to Medicare for prescription drug coverage. In Colorado, 336,858 people enrolled in standalone Medicare prescription drug plans.22
- Medicare Supplement Insurance: Medicare Supplement Insurance — also known as Medigap — is sold by private insurance companies. A Medigap policy covers some of the costs not covered by Original Medicare, such as copayments or your deductibles.
Medicare Savings Program
In Colorado, you may be able to get some help with your Medicare premiums, deductibles, and co-insurance if you can’t afford them. People with limited income and resources may qualify for the Medicare Savings Program (MSP). To be eligible, you must meet monthly income limits and have limited assets. For more information and to apply, visit the Department of Health Care Policy and Financing website.
Applying for health insurance in Colorado
No matter what your family size, income, or employment status is, there are several health insurance options available to you in Colorado. By exploring your options, you can find an affordable plan that works for your needs and gives you essential protection.