Everyone needs health care, and regular visits to the doctor are important. Because of new health care laws, you may qualify for free or lower-cost health insurance!
Health Insurance Assistance
The Open Enrollment Period is currently closed for health insurance coverage through Colorado’s Marketplace, Connect for health Colorado. There are Life Change Events that may qualify you to enroll outside of this time during a Special Enrollment Period.
You may still be eligible to enroll outside of Open Enrollment in a 60 day Special Enrollment Period if you have one of the following Life Change Events:
- Loss of minimum essential coverage (Includes Medicaid or employer-sponsored insurance)
- Birth of a baby, adoption of a child or placement of a child in foster care
- Change in marital status
- Change in legal residency or citizenship status
- Reaching age 26 and aging off of parent’s plan
- Move to a new permanent address in Colorado
- Changes in your income that affect the financial assistance for which you qualify for
- Change of tribal status
- Leaving incarceration
- Change of dependency status of someone on your plan
- Death of a covered member of your household
- Starting/ending AmeriCorps service
- Being incorrectly or inappropriately enrolled in a health plan for some reason that is not due to an error or omission on the part of Connect for Health Colorado
- Violation of the contract you had with your health insurance carrier
- Loss of an exemption to purchase health insurance coverage
Have questions? Make an appointment with a Health Coverage Guide.
- Receive answers to questions about life changes and how to report them
- Inquire about presentations of the Assistant Site services to organizations, employees or residents
- To check eligibility or start an application, please visit Colorado PEAK or Connect for Health Co
- Visit the event page to find a walk-in event near you.
- More Free In-person Help
Health Insurance Marketplace
Sometimes referred to as “the exchange”, Connect for Health Colorado is the state’s health insurance Marketplace. Individuals, families and small employers can shop for and buy health insurance through the Connect for Health Colorado website. Boulder County is a Certified Connect for Health Colorado Assistance Site and has trained Health Coverage Guides to help residents enroll in health insurance. Call 303-441-1000 or email firstname.lastname@example.org for more information or to make an appointment with a Health Coverage Guide.
Marketplace Helps People Who Are Not Eligible for Medicaid or Employer Based Coverage
With one application individuals and families can be evaluated for their eligibility for Medicaid/CHP+ and tax credits to help pay for private insurance in the Marketplace. The Marketplace is for U.S. citizens, legal permanent residents and all other lawfully present immigrants who currently buy insurance on their own, who are uninsured, or don’t have access to affordable coverage through their employer. Note: Deferred Action for Childhood Arrivals (DACA) permit holders are not eligible.
Tax Credit Lowers Your Monthly Premium
If you are eligible for tax credits, they can be applied directly to your monthly premiums in order to reduce your monthly payment. Tax credits are calculated by the Marketplace using your estimated 2016 household income. When you file your 2016 taxes, the Internal Revenue Service (IRS) will determine the correct amount of tax credit for which you are eligible based on your actual 2016 gross household income. Use the Individual Tax Calculator to estimate your tax credit.
- Connect for Health Colorado: www.ConnectforHealthCO.com
- Connect for Health Colorado: 1-855-752-6749 (1-855-PLANS-4-YOU)
- Boulder County Health Coverage Guide: 303-441-1000
Health Care Reform
The passage of the Patient Protection and Affordable Care Act in 2010 created a number of changes in the private and public health insurance system.
Key Changes Have Taken Place
- Young adults can now remain on their parents’ health insurance until age 26.
- Insurers can no longer deny coverage to individuals with pre-existing conditions or exclude those conditions from coverage.
- The 2016 out-of-pocket maximum for Individuals/Families is $6,850/$13,700
- Certain preventive health services, such as an annual exam, are provided at no cost to insured Coloradans through their plan’s network.
In January 2014, federal law mandated that all individuals are required to have health insurance. There are exemptions to the requirement, including people who have certain religious beliefs, people who are members of a federally recognized tribe or who cannot find an affordable plan. (Space) People who are not lawfully present in the United States and people who are incarcerated are also not subject to the mandate. The Internal Revenue Service (IRS) will be responsible for enforcing the requirement.
How More People are Accessing Affordable Insurance
Two changes that help more people meet the federal requirement to have health insurance:
- More individuals are able to qualify for health insurance through the Medicaid expansion, and
- A Premium Tax Credit helps lower- and middle-income families reduce the cost of their monthly premium when they purchase insurance through the Connect for Health Colorado Marketplace.
These changes have helped reduce the number of uninsured residents in Boulder County to 5%.
There are three forms for you and the IRS to use that indicate your insurance coverage history each year.
Individuals who have obtained insurance through the Marketplace will receive this form showing their months of coverage and any applicable tax credits.
Individuals who have been covered by Medicaid or CHP+ will receive this form showing their months of coverage.
Individuals who were offered coverage through their employer will receive this form indicating the months for which they were eligible for coverage. In some cases, the form also includes information on whether individuals and dependents were enrolled in health coverage offered by their employer. The employer is also expected to report this information to the IRS.
This form is used to show gaps in coverage and to apply for exemptions to the tax penalty for not having coverage.
This form is used to calculate your final tax credit amount based on your actual income earned. This information is then reconciled to the tax credits that were paid out on your behalf during the year based on the income estimate you used when you applied for assistance.
If you had Marketplace coverage in 2015 you should have received your 1095-A form before the end of February 2016. You can access your 1095-A form through your Connect for Health account in the “My Documents” section.
If you had Medicaid or CHP+ coverage in 2015, you should have received your 1095-B form before the end of February. You can access your 1095-B form through your PEAK account in the “Communications” section.
Did you have a gap in coverage?
You may be exempt from the tax penalty for not being covered for a variety of reasons, such as if your gap was only one month or two months in a row. Also, if you were out of the country for most of the past year, you may also be exempt.
Tax Information Resources:
In January 2014, Medicaid eligibility requirements expanded to 133% of the Federal Poverty Level (FPL) for all individuals. Colorado Medicaid already covered children up to 133% FPL, so the expansion increased coverage for parents with Medicaid-eligible children and to adults without dependent children.
Increase in Eligibility
The expansion means that Coloradans earning an income up to 133% of the Federal Poverty Level (FPL) will be eligible for Medicaid. See the current income limits for Colorado Medicaid . Children and pregnant women who are over income for Medicaid may be eligible for CHP+ Find out if you are Medicaid eligible and apply for benefits online by accessing Colorado PEAK
- Boulder County Housing and Human Services: 303-441-1000
- Boulder County Healthy Kids: 303-441-1589