Types of Colorado health insurance

Hundreds of individual healthcare plans are offered in Colorado. As with other healthcare exchanges nationwide, Connect for Health Colorado offers four different health insurance tiers that differ by cost.

  • Bronze: Bronze plans have the lowest premiums but the highest out-of-pocket costs. They pay approximately 60% of medical expenses, while the member pays the rest.
  • Silver: Lower premiums than any tier except Bronze, but higher out-of-pocket costs than Gold and Platinum; Silver plans pay approximately 70% of medical expenses.
  • Gold: Higher premiums than Bronze and Silver, but also lower out-of-pocket costs than those plans; Gold plans pay about 80% of medical expenses.
  • Platinum: Highest premiums but lowest out-of-pocket costs; Platinum plans pay approximately 90% of medical expenses.

Determining the metal tier that's right for you depends on several factors, including your financial status, health status and what you want from a health plan.

The best candidates for a Bronze plan include:

  • Healthy and young individuals who don't anticipate requiring many health care services.
  • Coloradans who desire to pay the cheapest premiums possible.

The best candidates for a Silver plan include:

  • Those who want lower premiums but wish to avoid high out-of-pocket expenses.
  • Households eligible for additional subsidies that are found in Silver plans.

The best candidates for a Gold plan include:

  • Those who don't want to spend as much when they need health care services in exchange for higher premiums.
  • Coloradans who believe they may need many health care services over the next plan year.

The best candidates for a Platinum plan include:

  • People who don't mind spending money on high premiums while paying the lowest out-of-pocket expenses when they need health care services.
  • Those who anticipate visiting the doctor often, use many health care services and have multiple prescriptions.

Best health insurance in Colorado

Six different insurers offer healthcare plans available via Connect for Health Colorado:

  • Anthem Blue Cross Blue Shield
  • Cigna
  • Denver Health
  • Kaiser Permanente
  • Rocky Mountain Health Plans/UnitedHealthcare
  • Select Health

Determining which health insurer and plan are best for you depends on your needs and health care coverage goals. To help narrow down your choices, ask yourself:

  • Are your preferred physicians and providers within the plan's network?
  • Does the plan cover your prescription drugs?
  • Do you prefer paying lower premiums but higher out-of-pocket expenses when it's time to see a provider?
  • Or is paying higher premiums but lower out-of-pocket costs when health care is needed more desirable?

"There is no such thing as the 'best health insurance plan.' Everyone has different needs, so the best plan for you or your family may be unsuitable for another," says John Bartleson, owner of Health Benefits Connect in Englewood, Colorado.

Two different health plan types are offered by Connect for Health Colorado (PPOs are not an option):

  1. Health maintenance organization (HMO) plans: These are commonly less expensive than EPOs but are more restrictive. If you want to see a specialist in the network, you will likely be required to choose a primary care physician and obtain referrals from that provider. Additionally, HMOs usually don't cover costs for out-of-network care unless it's an emergency.
  2. Exclusive provider organization (EPO) plans: Like an HMO, you must remain within your plan's network with an EPO, but you don't have to select a primary care physician or obtain referrals to visit a specialist. Generally, a larger number of doctors and hospitals are considered in-network with EPOs.

Learn more about each of these health plans and what makes each different.

You can also shop for a dental benefits plan through Connect for Health Colorado. Families and individuals can select from 12 different dental plans provided by four insurers:

  • Anthem Dental Coverage
  • Cigna Dental
  • Delta Dental
  • Solstice

Connect for Health Colorado offers two dental plan designs: HMOs and PPOs.

Colorado has no individual mandate or penalty

The Affordable Care Act previously required most Americans to obtain health care insurance (called the "individual mandate") or pay a penalty fee. But in recent years, Congress removed the individual mandate penalty on the federal level. The same is true in Colorado.

However, just because health insurance isn't a requirement and there is no fee for going without it doesn't mean you shouldn't get coverage. In fact, going without health insurance can lead to devastating financial and health consequences. Consider that, per an American Bankruptcy Institute study, you’re twice as likely to file for bankruptcy if your health insurance is interrupted.

Expanded health insurance subsidies in Colorado

The ACA created subsidies to help Americans pay for marketplace plans. You can qualify for subsidies that lower your monthly premiums based on your income compared to the federal poverty level (FPL). As of 2024, the calculation works on a sliding scale. 

If your income is 250% FPL, you will only be required to pay up to 4% of your household income toward healthcare premiums. The 250% FPL benchmark in 2024 is $36,450 for an individual and $75,000 for a family of four.

If your FPL is 400% or higher, you pay no more than 8% of your household income on healthcare premiums. In 2024, 400% FPL is $58,320 for an individual or $120,000 for a family of four. 

Kaiser Family Foundation offers a tool that estimates health insurance costs for a marketplace plan.

The Connect for Health Colorado website will request your household income, size and location. With that information, the website will provide cost estimates for plans with subsidies in mind.

Colorado households beneath subsidy eligibility may qualify for Health First Colorado, the state's Medicaid program. Health First Colorado provides low-cost, comprehensive healthcare plans based on household income.

How much is health insurance in Colorado?

Health insurance costs vary based on premiums, deductibles, out-of-pocket costs and various other factors.

Here are the differences in average lowest premium costs between three of the plans for 2024:

  • Bronze: $327
  • Silver: $433
  • Gold: $407

Source: KFF

The Kaiser Family Foundation didn't estimate Platinum plans, comprising only a small portion of Affordable Care Act plans.

Note that these average costs don't consider subsidies that may apply. Remember that if you qualify for subsidies, you'll likely pay much less than these average premium costs.

"Health insurance premiums are set by the state commissioner, so the monthly premiums are the same whether you purchase the plan online, through a brokerage or directly through an insurance company," says Bartleson.

How to buy health insurance in Colorado

Coloradans can get a Connect for Health Colorado plan during annual open enrollment, which typically runs from Nov. 1 to Jan. 15. More than 237,000 Coloradoans enrolled in a health insurance plan by the conclusion of the most recent open enrollment period.

Additionally, you can sign up for a Connect for Health Colorado plan during other times if you qualify for a special enrollment period. You may be eligible to receive a Connect for Health Colorado plan if you have:

  • Lost your job
  • Lost your health insurance
  • Moved
  • Turned 26 and are not eligible to stay on a parent's plan
  • Married or entered into a domestic partnership
  • Had a new child
  • Been impacted by wildfires
  • Become a U.S. citizen
  • Experienced a change in household size
  • Returned from active military service
  • Been released from prison or jail

These qualifying events will initiate a special enrollment period. If one or more of these incidents apply, you will have 60 days to enroll or change your health care plan. To sign up, visit the Connect for Health Colorado website, phone 855-752-6749 or apply with a certified enroller or broker.

"Wading through lots of options for coverage is often a daunting task for families. An insurance broker can easily find and customize plans and clearly explain these options to the customer," says Bartleson.

To enroll, gather the following documents:

  • Federal tax information (if you file)
  • Social Security numbers or immigration documents
  • Income and employer information for your household

Connect for Health Colorado will confirm your information using government databases.

Shop around for health insurance in Colorado

It pays to shop around among various health insurance plans and insurers and compare and contrast what you find carefully.

"Understanding different plans and coverages can be difficult, so working with a professional is always a good idea," suggests Bartleson. "This reduces any surprises and small print issues further down the road."

COBRA insurance in Colorado

If you have recently lost your employer-sponsored group healthcare insurance coverage, you may be eligible to enroll in a COBRA plan. This option allows you to continue your plan previously provided by your former employer for a limited time – typically between 18 and 36 months.

Keep in mind that, with COBRA, you pay all the expenses, including premiums, copays, deductibles and other out-of-pocket costs. Your previous employer will not contribute money to help offset your premiums.

The federal COBRA law only pertains to employers with 20 or more employees. States often have mini-COBRA laws that cover former employees of businesses with fewer employees. In Colorado, you can have a COBRA plan for up to 18 months if you were employed by a small business.

Other ways to get health insurance in Colorado

Aside from Connect for Health Colorado, an employer-sponsored group plan, Medicare and Health First Colorado (Medicaid). Coloradoans may also obtain health care coverage in other ways:

  • An individual private plan outside of the Connect for Health Colorado exchange
  • A catastrophic plan

The downside of individual private plans not offered through Connect for Health Colorado is that these plans don't qualify for subsidies. Consequently, shopping for and obtaining a healthcare plan through Connect for Health Colorado may be best if you’re eligible for subsidies.

As a last resort, consider a catastrophic plan. Only people under age 30 or who qualify for a hardship exemption are eligible. While they come with much higher out-of-pocket costs, catastrophic health plans provide many benefits similar to traditional healthcare plans. You can enroll in a catastrophic plan directly with an insurer if you are eligible.

If you qualify for a catastrophic plan, compare the plan with a Bronze plan in the marketplace. You may find a Bronze plan with similar premiums and lower deductibles.

Although short-term health insurance is sold in some states, it isn’t available in Colorado. 

Still not sure about health insurance eligibility? Check out Insurance.com's Health Plan Finder to explore your health insurance eligibility.

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