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Colorado Health Insurance
Shopping for health insurance in the state of Colorado might seem like a daunting task. Thankfully, there are many options open to residents of Colorado who are uninsured or underinsured. Whether you're healthy or not this page will provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage, and about COBRA. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, HealthPlanOne can help. If not, review the information on this page about Colorado Medicaid, high risk pool, and CHIP. All of these government programs can help those who are medically uninsurable or who cannot afford private insurance to obtain basic health coverage.
What Every Colorado Resident Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through HealthPlanOne. Simply visit our Short-Term information page for your free quotes.
It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through HealthPlanOne.
With individual coverage you choose the health insurance carrier and benefits you want with the help of HealthPlanOne. We will quote plans for you and your family from all the different carriers available in Colorado so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through HealthPlanOne could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Colorado each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the HealthPlanOne quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Sole Proprietor and Small Group Plans
Your first option is to see whether you qualify for a sole proprietor plan. A sole proprietor is someone who is the sole owner and only employee of their company. If you are self-employed and this is your situation, you could qualify for a sole proprietor plan in Colorado. In order to qualify you have to have been in business for at least 1 year before applying for coverage. You must also apply within 31 days of the sole proprietor's birthday, the one year anniversary of the business start date, or loss of your previous coverage. There is medical underwriting when applying for a sole proprietorship, but it's not as stringent as the underwriting on the individual plans. If you have considerable medical issues and are applying for a sole proprietorship, the carrier can deny your plan of choice but they cannot deny you coverage period. They must accept you for coverage, but if your medical problems are very serious, they may only accept you to their most basic plan, rather than the rich-in-benefit plan you originally wanted. Sole proprietor plans will cover not only the small-business owner but also his or her family.
If you own a small business but are not a sole proprietor, you can apply for a small group plan. You must have 2-50 eligible employees who each work at least 24 hours per week. Small groups which meet these requirements cannot be denied for coverage by carriers to the plan they apply for.HealthPlanOne can help you by quoting plans for both sole proprietors and small groups. Simply call our toll-free number at (877) 567-5267.
To view small business group plans in Colorado, visit our Colorado Small Business Group page.
Medicaid works in practice much like having regular health insurance; if you qualify you'll receive a Medicaid card which you can show your doctor at an appointment. If your doctor participates in Medicaid, the state will pay the bill for the appointment minus any other health insurance you may have. The program pays for many medical services including in- and outpatient hospital care, laboratory services, nursing home care, home health care, transportation necessary to receive medical care (ambulance rides), and other services. Medicaid (also known as Title XIX) can be used to pay for health care services if you are receiving AFDC or State Supplement benefits, disabled or legally blind, 65 years or older, under 21 years of age, or pregnant. For information on benefits and specific eligibility requirements, click here:http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1198141245169
For information on the managed care aspect of Medicaid, click herehttp://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197969485561
For information on all other programs under the Medicaid umbrella, click herehttp://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197969485536
To learn more about the pharmacy coverage associated with all programs under Medicaid, click here:http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542648884
For information on Colorado Medicare, please visit MedicareSolutions.com
Long Term Care
The long-term care aspect of Medicaid makes benefits available to residents who require ongoing medical or social support and services. You must prove financial qualification as well as level of care qualifications to be eligible. For full eligibility requirements as well as a list of covered benefits, click here: http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197969485604
Child Health Plan Plus
CHP+ provides health insurance coverage to low-income children (18 years and younger) and pregnant women (19 and older) who are Colorado residents. Benefits include inpatient and outpatient hospital services, physician services, prescription drugs, dental for children and mental health services. There are income and other eligibility requirements which are available at http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197969485551
CO Indigent Care Program (CICP)
The CICP is responsible for distributing funds to partially compensate qualified health care providers for uncompensated costs associated with services given to indigent residents of the state. CICP does not constitute a health insurance program or creditable coverage of any kind. Local hospitals and clinics will enroll families in CICP. To be eligible for discounted services under the program applicants must meet both residency and income/asset requirements. To learn more about the program and its benefits, click here: http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1214299805914
CoverColorado is the state's high risk pool option. The pool serves as the "insurer of last resort" for residents whose pre-existing medical conditions have rendered them medically uninsurable on the individual market. In order to be eligible for coverage under CoverColorado you must not be eligible for Medicaid or Medicare, be a resident of Colorado, been denied coverage by an individual carrier for one of a list of pre-existing medical condition, and several other criteria. For benefit summaries and detailed information, click here: https://www.covercolorado.org/Pages/Default.aspx