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Colorado Health Insurance
An affordable health insurance policy is a universal necessity, especially if you are the sole earning member of a family. Health insurance from a private insurer can be expensive. You need to assess your finances and the potential risks associated with your family’s health. Approximately 47 million Americans do not have a proper health insurance in place. Majority of these uninsured people are the working families, who are exposed to the risk of crushing medical bills. Those families who are not covered by their employer’s group coverage can avail their state-sponsored low-cost health insurance programs.
Colorado is the 19th healthiest state to live in, according to the America's Health 2008 Rankings. However, the state has not shown any kind of improvement, as it held the 16th position for two consecutive years of 2006 and 2007. Colorado’s health care system is rather strong, but, the state lawmakers needs to focus on increasing public funding and providing better health care access to the uninsured population. The state of Colorado, having the population of more than four million residents, offers both private-market and public health insurance alternatives. The private-market health insurance comprises of numerous types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide low-priced health coverage to the uninsurable residents of Colorado who meet specific eligibility requirements.
The Colorado Division of Insurance Alaska Insurance Department regulates all types of insurance sold in the state including health insurance policies offered by private-market health insurers or public health coverage programs. However, approximately 16.9% of the population remains uninsured, which is the top priority for the Colorado government. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, approximately 38.3% of Colorado residents under the above 200% FPL category continue to live in the state without any kind of health insurance.
Health insurance is an inevitable option; therefore, your best interests remain in taking professional help from a licensed health insurance agent/broker to avail the benefits of appropriate health insurance coverage.
Individual/Family Health Insurance
Below is the guidelines for applying for and obtaining individual health insurance in the state of Colorado. These regulations apply to all insurance companies offering individual or family health insurance in Colorado:
Medical Underwriting | Yes |
Pre-Existing Condition Exclusion Period | 12 months |
Look Back Period | 12 months |
Look Back Standard | Objective |
Mandatory Benefits | Cancer screening for women including breast cancer screening, direct access to OB/GYNs, depression parity |
Market Rate Restrictions | NA |
Guaranteed Issue Options | None |
Small Group Health Insurance
Below is the guidelines for small group health insurance in the state of Colorado. These regulations apply to all insurance companies offering small group health insurance in Colorado:
Small Group Size | 1-50 |
Employee Qualifications |
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Guaranteed Issue | Yes |
Premium Rating Factors | Adjusted Community Rating |
Rate Adjustment Factors | +10% or -25% |
Look-Back Period | 6 months |
Pre-existing condition exclusionary period | 6 months |
Mandatory Benefits | Same as individual |
State Cobra Variations for Small Groups
Below are the COBRA guidelines for small groups in the state of Colorado. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:
Mini-Cobra Option | Yes |
Eligible Group Sizes | 2-19 employees |
Extension of Benefits Period – Standard | 18 months |
Extension of Benefits Period – Disabled | 18 months |
Maximum Premium Increase | 100% |
State Legislation Reference | Colorado Revised Statutes 10-16-108 |
Additional Notes | Individuals or their dependents must have 6 months of continuous coverage under the group policy to be eligible and have 30 days from termination date to accept coverage under Colorado continuation laws. |
State Sponsored Health Insurance Programs
There are several state sponsored health insurance programs in the State of Colorado to assist those without insurance in obtaining adequate coverage.
High-Risk Pools
Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of Colorado is summarized in the chart below:
Plan Name | Cover Colorado |
Website | |
Phone Number | 877-461-3811 |
HIPPA Eligibility Required? | Yes |
Available Carriers | PacifiCare |
Pre-Existing Condition Waiting Period | 6 months |
Enrollment Periods | Open |
Premium Limits | No more than 150% of standard rates |
Lifetime Maximum Benefit | 1 million |
Special Notes | Eligible individuals should :-
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Children’s Health Insurance Program
Through shared funding from the federal government, the State of Colorado provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:
Program Name | Child Health Plan Plus (CHP+) |
Website | |
Phone Number | (800) 359-1991 |
Apply Online | Yes |
Age Limits | Children age 18 and younger and pregnant women age 19 and over |
Insurance Carrier | Colorado Access, Denver Health Medical Plan, Rocky Mountain, Kaiser Permanente |
Length of Coverage | 12 months |
Residency Requirements | Colorado residents, Permanent legal residents who have had an Alien Registration number for at least 5 years, a refugee or asylee |
Other Eligibility Requirements |
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Pre-Existing Condition Exclusions | None |
Cost | Annual enrollment fee is $25 for one child, $35 for 2+children. Co pays are $2 - $15 per visit for routine medical care |
Medicaid
Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Colorado:
Governing Agency | Colorado Medicaid |
Website | http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197364086675 |
Phone Number | 303-866-2993 |
Federal Poverty Line Income Limits | Pregnant women and children under the age of 6 income at or below 133% of the FPL |
Additional Resources
Colorado Health Care Options Matrix™ Guide
Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Colorado’s public and private health care choices for individuals and groups with various demographic profiles.
Family Health Insurance Guide by HealthInsuranceFinders.com
The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.
Colorado: At-A-Glance
Provides exclusive health data of Arkansas. Statehealthfacts.org, a project of the Henry J. Kaiser Family Foundation, provides free, up-to-date, and easy-to-use health data on all 50 states.
