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Are you a Coloradoan under age 65 scouring the market to discover the right health insurance coverage? What does health insurance in Colorado look like for people in this age group? In the Centennial State, you have several coverage options to consider.
Connect for Health Colorado
The official health insurance marketplace for the Centennial State is called Connect for Health Colorado. The program aims to help individuals, families, and small businesses afford quality health coverage. When a Coloradoan does not have health insurance from an employer, Medicare, or Medicaid, this initiative provides competitive health insurance. Metal tiers exist to distinguish the varying premiums, deductibles, and copayments for individuals. Bronze plans offer the lowest monthly premiums yet the highest deductibles and copayments. Individuals who buy silver plans have moderate premiums, deductibles, and copayments. Gold plans are at the other spectrum range and require higher monthly premiums but lower deductibles and copayments. Catastrophic plans remain available for people under 30 years of age. For 2024 and again in 2025, Coloradoans will have individual marketplace plan options from six insurance companies.
- Anthem (as HMO Colorado)
- Cigna
- Denver Health
- Kaiser Foundation
- Rocky Mountain HMO
- Select Health
Which plans are available in your area will vary based on your county of residence. According to the Colorado state government, for plan year 2025, “[o]ver 96% of Coloradans will be able to choose plans from at least two insurance companies for individual plans available through Connect for Health Colorado (Colorado’s on-exchange marketplace), and over 75% of Coloradans will be able to choose plans from five or more companies. Each company offers multiple plans across multiple metal tiers/price levels.” Also, in 2025, 219 plans will be available for the individual marketplace among the six insurance companies listed above.
Open enrollment begins on November 1, 2024, and ends on January 15, 2025. Remember, December 15 is the last day to enroll or change plans for your coverage to begin on January 1.
Are you unsure if you can afford one of these plans? You may qualify for a premium tax credit (PTC). Individuals and families with incomes between 100% and 400% of the Federal Poverty Level (FPL) may qualify for tax credits to lower monthly premiums. The government can issue these premium tax credits upfront to lower your monthly premium costs, or you can claim them when you file taxes. In previous years, cost-sharing reductions (CSRs) are also available to individuals and families with incomes between 100% and 250% of the FPL. CSRs lower out-of-pocket costs (co-insurance, co-pays, and deductibles) for those who qualify. These reductions are only available if you enroll in a Silver plan on the marketplace. However, in 2025, fewer Coloradoans will be eligible for CSRs. “Households with incomes between 200-250% of the federal poverty level will receive less reduction on silver plan co-pays, deductibles, and co-insurances, decreasing to 73% actuarial value plans from 94% in 2024.”
Medicaid and CHP+
Health insurance in Colorado is also available through Medicaid and Child Health Plan Plus (CHP+) for low-income individuals who qualify. The Medicaid program in Colorado is known as Health First Colorado. “Children, pregnant women, parents and caretakers, people with developmental, intellectual, and physical disabilities, and adults can all potentially qualify” for Health First Colorado. The CHP+ is inexpensive health insurance for certain children and pregnant women. Approved applicants for CHP+ earn too much to qualify for Health First Colorado but not enough to pay for private health insurance. For full details on qualifying for these programs, visit Colorado’s PEAK website, where Coloradoans can apply and manage their medical benefits online.
Private Insurance and Employer Coverage
If you can afford it, private insurance can be an advantageous purchase. Private health insurance in Colorado often presents admission to a more extensive network of doctors, specialists, and hospitals. Usually, you also can choose your primary care physician and visit specialists without a referral. Customizable coverage plans are another hallmark of private health insurance. You may be able to add specific riders for mental health services, physical therapy, or maternity care. Some specialized procedures or specific prescription drugs may not be covered by public health insurance, but private health insurance can feature this perk.
Employer coverage is another attractive option for individuals. If your employer offers health insurance, they will share the costs with you, the employee. In 2023, the Kaiser Family Foundations conducted a national survey and found employers averaged paying 79% of an employee’s single coverage and 66% of an employee’s family coverage. Employer-sponsored plans also offer a wide range of benefits and access to a broader provider network. Do you have a spouse and children? Often, employer health insurance will cover your dependents, including dependent children up to age 26. Stability is vital in every aspect of life. When you remain employed by your boss, generally, you do not lose your coverage or need to apply again each year for a health plan. If you lose your health insurance coverage from another employer, Medicaid, or CHP+, be aware that your current employer might have a set time limit for joining their large-group insurance (100+ employees) or small-group insurance (99 or fewer employees).
Does Colorado Have Short-Term Health Insurance?
Unfortunately, short-term health insurance is not available in Colorado. In April 2019, the state government made selling short-term plans nearly impossible in Colorado, so insurance companies no longer offered short-term coverage to Colorado residents.
So, what is a Colorado resident to do if you are in between jobs and do not have insurance? Health-sharing plans could be your solution. Members of health-sharing plans pay a monthly contribution instead of premiums. The contribution goes into a collective account where administrators use those funds to pay for their members’ qualifying medical expenses. Interestingly enough, some health-share programs allow members to know who their money is helping, and these members can contribute more to the collective account to specifically aid that person. Maybe a health-share plan is not ideal for you. If you lack health insurance coverage and do not know what to do, contact Empower Brokerage at (888) 446-9157 to speak with one of our friendly licensed agents to help you find the right plan for your specific needs.
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