Colorado Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
November 4, 2020

People in Colorado can sign up for health insurance today, due to coronavirus. The state has opened up the Open Enrollment Period sooner than the regularly scheduled November 1 start date. If you live in Colorado, you have some options for health plans so it’s important that you shop carefully. If you’re an individual or you’re buying coverage for a family, you can get the coverage you need at the best prices by comparing rates with SmartFinancial. If you do not buy health insurance by the end of the Open Enrollment date, you may only be able to sign up during the Special Enrollment Period due to a qualifying event or you may have to wait until next fall to buy insurance.

When Is Open Enrollment in Colorado?

November 1, 2020 - December 31, 2020. Coverage begins January 2021.

How to Get Health Insurance in Colorado

First, start by estimating what your healthcare needs will look like in 2021. What were they like last year? How often do you anticipate needing to see a doctor? Do you have any scheduled surgeries? Do you need to stay with specific doctors? There are many moving parts to choosing a new health plan, but to buy the most cost-effective one, you must consider which tier plan will save you the most money this year. To do that, you must look deeper than the premium price.

The smartest way to get the most competitive rates for the coverage you need is to compare health insurance companies and health insurance quotes. When you submit a brief questionnaire with SmartFinancial, you’ll receive several health insurance quotes from a health insurance agent in your area. This is your chance to ask questions about the plans you’re considering.

What Types of Health Insurance Are Available in Colorado?

HMOs, EPOs, PPOs and POS plans are most commonly available in Colorado. You also have four levels of coverage to choose from: platinum, gold, silver and bronze. Platinum covers the most (90%) but costs more each month, whereas bronze has the least coverage (60%) but costs the least each month. So, with a lower-tier plan, you’re paying more for coinsurance and copays, which can run as high as $100 or more per doctor visit. However, if you’re young and healthy and rarely see a doctor, this may be the most economical choice.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

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Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • When you lose or quit a job and have no health coverage, you may sign up outside the open enrollment period. You are also eligible, if you started your own business or if a new job doesn’t offer health insurance.
  • When you turn 26 and cannot stay on your parents’ health insurance plan, you can enroll in an individual one.
  • If you moved to another state or out of a coverage area, you can sign up for a new health plan.
  • When your Cobra extension expires, you can enroll in a new health plan.
  • If you divorce, you may be eligible for a new health plan if you previously shared coverage with the former spouse.
  • When you marry, you can add a spouse to your plan (or vice versa) or you can buy an entirely new one together.
  • When you have a child or adopt one, you can buy health insurance for that child.
  • If your health insurance coverage depended on a spouse or partner that passed away, you may enroll in an individual plan.
  • Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Colorado?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is the only way to prevent medical bankruptcy.

How Much Is Health Insurance in Colorado?

The average cost of health insurance in Colorado for a 40 year old is about $358 a month, which is lower than it is in most states. Health insurance gets more expensive as you age. Tobacco use also increases your rates.

How to Save on Health Insurance in Colorado

The easiest way to save on health insurance in Colorado is to compare rates based on the tier system. Buy a plan based on your projected costs for the year.

Medicare in Colorado

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Colorado?

16% of Colorado’s population is insured through Medicare.

How Much Is Medicare in Colorado?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income. .

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Colorado

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Arkansas?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Colorado State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Colorado Health System are listed below:

  • Colorado: Overall Ranking: 6 of 51
  • Colorado: Overall Performance: Above U.S. Average
  • Colorado: Access and Affordability: 24
  • Colorado: Prevention and Treatment: 6
  • Colorado: Avoidable Hospital Use and Cost: 4
  • Colorado: Healthy Lives: 6
  • Colorado: Health Care Disparities: 13
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Colorado Health Insurance Coverage

The people of Colorado have different kinds of health insurance while some Colorado residents are not insured at all. See the breakdown below:

  • Private coverage: 55%
  • Medicaid: 20%
  • Medicare: 16%
  • Uninsured: 9%

Report: America's Health Insurance Plans

Colorado Health Insurance Companies

  • HMO Colorado, Inc.
  • Kaiser Foundation Health Plan of Colorado
  • Aetna Life Insurance Company (Colorado)
  • Denver Health Medical Plan, Inc.
  • Humana Health Plan, Inc. (Colorado)
  • Rocky Mountain Health Maintenance Organization, Inc.
  • Rocky Mountain Heathcare Options, Inc.
  • United Healthcare Services, Inc. (Colorado)
  • UnitedHealthcare Insurance Company (Colorado)
  • Cigna Health and Life Insurance Company (Colorado)
  • Connecticut General Life Insurance Company - Colorado
  • UnitedHealthcare of Colorado, Inc
  • Anthem Blue Cross and Blue Shield of Colorado (Rocky Mountain Hospital and Medical Services, Inc.)
  • Cigna HealthCare of Colorado
  • UnitedHealthcare Military & Veterans Services, LLC
  • Compass Rose Health Plan

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