Do you need comprehensive, affordable health insurance in Colorado? We’ve got you covered. Well, not us, specifically – but we can give you tons of helpful information and help point you in the right direction towards the best health insurance policy for you. Whether you’re looking for something from the ACA, short-term health insurance, a Christian health plan, or more, this article can help you learn everything you need to know to make the right decision for you and your family.
Major Medical Insurance in Colorado
It’s hard to believe how time flies, but the Patient Protection and Affordable Care Act has been around since 2010. It was signed into law by President Barack Obama in the spring of that same year, and has helped countless millions of people find affordable and comprehensive major medical health insurance coverage. It has literally been a life-saving effort for some people. That being said, the law has changed several times over the years, and it’s important to go over some of the more important changes which affect you and your family’s health care needs.
In Colorado, you can either apply for a subsidized health insurance plan on the state exchange (more on that later) or through HealthCare.gov. If you go through HealthCare.gov, the Open Enrollment period starts on November 1st and ends December 18th, 2020. The application process is fairly simple and straightforward. Most people earning a certain income above the federal poverty level will qualify for a large enough federal subsidy that it makes your monthly premiums realistically affordable.
There are two very important reasons that Marketplace insurance is superior to other types of coverage available to most consumers. Number one, all of the policies are guaranteed issue. When you apply for a guaranteed issue policy, you cannot be rejected based on your sex, or any preexisting conditions you may have. In fact, the only things which can legally affect your monthly premium are:
- Your age
- Your location
- Your use of tobacco products
- Whether you are applying for an individual policy or a family policy
The second reason ACA plans are some of the best major medical plans around has to do with the Essential Health and Wellness Benefits that are guaranteed with each plan. Those benefits include:
- Ambulatory/outpatient services
- Emergency services
- Hospitalization
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
The general rule is that people who make at least 138% of the federal poverty limit (depending on household size) should qualify for a federal ACA subsidy. But the thing that complicates matters is the fact that Colorado has its own state health insurance exchange where residents are expected to apply for health insurance coverage and financial assistance. If you make below the 138% poverty threshold, then you will have to apply for Health First Colorado, the state’s Medicaid program. If you make above the threshold, then you can apply for major medical insurance through the state exchange. In addition to federal subsidies, you may also qualify for certain healthcare discounts if you purchase through the state exchange. But you’ll have to apply through the state exchange in order to find out whether or not your annual income before taxes qualifies you for these discounts which are unique to the state of Colorado.
The Colorado State Exchange
Connect for Health Colorado is the local health insurance marketplace for the state. It works similarly to the federal Health Insurance Marketplace, but it has an expanded Open Enrollment period which starts on November 1st, 2019 and ends January 15th, 2020. A household of one individual who makes at least $16,612 per year before taxes can qualify for financial assistance which lowers their monthly premiums and entitles them to money-saving healthcare discounts. If you make less than that, then you may be better off applying for Health First Colorado instead. For more information on the Colorado state exchange, click here.
Short Term Health Insurance in Colorado
Due to the passage of the ACA and the way it’s laws have changed the insurance landscape within the state, short-term health insurance is no longer an option in Colorado. This was official as of September 1st, 2019. The state legislature kept passing incremental changes to short-term health insurance laws in order to make them increasingly more similar to coverage that was ACA-compliant within the state. Eventually, the lack of financial profits drove all short-term health insurance providers out of the state. But Colorado has also made several efforts to expand access to affordable and discounted ACA-compliant health insurance plans in recent years, so the vast majority of residents shouldn’t be adversely affected by this change.
Christian Health Plans/Health Share Plans in Colorado
In the beginning of the Affordable Care Act, there was something called the individual mandate. It said that people had to either get qualifying health insurance coverage through their employer, purchase health insurance through the ACA Marketplace, or purchase a qualifying health plan which gave them an exemption. Christian health plans qualified as one of those exempted plans. But since individual mandates don’t exist anymore on a federal level, and since Colorado is not one of the states which enforce an individual mandate on its citizens, Christian health plans have largely gone out of style for most consumers.
For some people, especially those who can’t afford an unsubsidized ACA plan, they may still have an appeal. After all, they have many things in common with short-term health insurance, such as:
- No guaranteed issue
- Unlimited out-of-pocket costs
- Lifetime and annual benefit caps
- No guaranteed Essential Health Benefits
- Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
- Not considered to be a “real” health insurance plan by major organizations and care providers
There are some significant differences between short-term health insurance and a Christian health plan that you should be aware of, however. For one, the jargon is a little bit different. For most people, the practical differences are mostly semantics, but there are legal reasons for it, too. Your monthly premium is actually referred to as a “monthly share amount”, and charges such as co-pays, coinsurance, and deductibles are lumped together under the category of “unshared amounts” or “personal responsibility amounts”. Furthermore, there is no contract between you and your Christian health plan provider. If they surprise you by denying benefits for payments on a specific claim, you likely won’t have any legal recourse to dispute their refusal. Lastly, you should know that Christian health plans typically impose participation guidelines on their members; these guidelines usually involve things like declaring a specific (mostly Christian) faith, immediately ceasing the use of all tobacco products, and other lifestyle habits and behaviors which coincide with a biblical way of life.
Fixed Indemnity Plans in Colorado
If you purchased a fixed indemnity insurance plan, you are essentially signing up for financial assistance with paying your hospital bills on a per day, per week, per month, per visit, or per incident basis. Health insurance supplements like Aflac or cancer insurance are popular examples of a fixed indemnity plan. But don’t be fooled into thinking that these are a comprehensive, adequate replacement for a full coverage major medical insurance policy. At best, these plans can supplement major medical insurance so that you are protected from out-of-pocket hospital costs that your plan won’t cover. But they won’t cover your basic health needs.
As with many other so-called major medical “alternatives”, fixed indemnity plans don’t subject themselves to the same regulations or rules that major medical plans do. So they can impose certain things on their customers – such as lifetime and annual benefit caps and medical underwriting – that you wouldn’t have to deal with from a major medical plan. Unfortunately, not everyone can qualify for major your medical coverage. Furthermore, even if you can’t afford a major medical plan, fixed indemnity plans can still be very useful and pay for themselves over time if you know that you are going to be facing a substantial amount of hospital costs. So they can be worth looking into under certain circumstances.
Discount Cards in Colorado
Medical discount card programs are different from one state to the next. In Colorado, the vast majority of medical discount cards available to the average consumer offer discounts on prescription drugs only. But these cards in general work the same way you can expect an AARP discount card or a AAA discount card to work: you pay membership dues on a monthly or annual basis, get your card in the mail, and present the card whenever you purchase prescription drugs. Then you get a discount whenever you go and purchase your drugs at the pharmacy. These cards aren’t a replacement for major medical coverage, nor are they a prescription drug insurance supplement; but they can at least take the edge off of your out-of-pocket prescription drug costs.
Unfortunately, discount card programs aren’t always as closely regulated as they should be and tend to leave people more vulnerable to scams than other types of medical aid. For starters, anyone who advertises their prescription drug discount card as a replacement for major medical coverage is lying to you. So don’t buy into the hype if it looks like they’re trying to convince you that a medical discount card can replace regular health insurance. Next, if the discounts they advertise sound too good to be true, follow up. Look for business reviews of the company and try to get feedback from real, live customers who have used the card. Call up the retailers that the company claims they’re affiliated with and double-check to make sure they offer the discounts which are advertised. If you don’t, there’s a good chance you may waste money on membership fees for a discount card which won’t actually get you any real, money-saving discounts. And considering how expensive prescription drugs are these days, that can be a real problem if you aren’t careful.