Individual Health Coverage

The individual health insurance market has changed markedly since the implementation of the Affordable Care Act, sometimes referred to as Obamacare.

Plans come in 3 categories, Bronze, Silver and Gold. From a 20,000′ perspective, the category determines when the insurance company steps in front of you and starts taking some or all of the bullets. However, it’s important to keep in mind that the services covered are the same in all categories of plans, the difference is when the insurance company starts paying. Each company has their own network of doctors and drug formularies

Pricing is based on your region (i.e. zip code/county) and age. Your health history does not affect your premium. The cost of insurance may be reduced if you are eligible for a tax credit. In Colorado, to obtain a tax credit on a monthly basis (i.e. have it advanced) you must apply for Medicaid. This can be done through your Connect for Health Colorado account or through the Colorado PEAK website.

So far, each year has been a new adventure. In 2018 the following insurance companies participated in the Colorado Marketplace:

  • Anthem BCBS (entire state)
  • Bright Health (7 counties, some of them partial counties)
  • Cigna (7 counties)
  • Elevate by Denver Health (Denver region)
  • Friday Health (regional)
  • Kaiser (regional)
  • Rocky Mountain Health Plans (Mesa county only)

If you live outside the front range area, your selections were limited to Anthem and perhaps Friday Health.

2018 open enrollment ended January 12th. You can enroll in an ACA plan outside of open enrollment if you have moved to the state OR had an involuntary loss of coverage. Other options outside of open enrollment are short term medical and Health Care Sharing Ministry (HCSM) plans. HCSM plans, while not ACA compliant are exempt from the penalty. They do require a statement of faith that varies from company to company.