En español | Most Coloradans are eligible to buy health insurance through Connect for Health Colorado, the state’s Affordable Care Act (ACA) marketplace, with open enrollment running through Jan. 15. 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 52 percent on monthly premiums.
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.
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:
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:
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.
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.
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.
Most Connect for Health Colorado plans are organized into three categories:
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.
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.
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.
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 Nov. 1 to include information about open enrollment.
This story is provided by AARP Colorado. Visit the AARP Colorado page for more news, events, and programs affecting retirement, health care, and more.
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