Do you have no health insurance and now wish you did? Connect for Health Colorado, which is Colorado’s health insurance marketplace, has opened a Special Enrollment Period (SEP) through April 30 so that people can get health insurance if they don’t have it.
When you enroll, you’ll check the box that says you are enrolling due to COVID-19. If you sign up during this SEP, your insurance will start May 1, and you will need to re-enroll in December if you want to stay on the marketplace. You can go back to employer insurance if you get a job again later.
Did you lose your health insurance when you lost your job? You always get a 60-day SEP to sign up on the marketplace when you lose health insurance due to losing your job, for any reason. When you go to Connect for Health Colorado, you can also find out if you are eligible for Medicaid, called Health First Colorado.
The Connect for Health website has been streamlined, and is easier to use than it used to be. Just answer the questions as straight as you can. Here is some help with understanding the process of applying, and how to use the website to find out if you qualify for any financial assistance.
There are different ways people can get financial assistance in paying for health insurance. First, your income in relation to your household size could get you a monthly discount on your premium, called a “Premium Tax Credit.” You can get an estimate of what this discount will be and see the approximate costs for plans. Second, you may qualify for Health First Colorado, Colorado’s expanded Medicaid Plan. Third, your children may qualify for CHP+, for which you pay a low monthly fee.
There are a few other special circumstances where you might get assistance paying for insurance, but these three are the most common.
Many people don’t know that most hospitals and some doctors’ offices will waive part of a bill if you have a financial hardship. If you get a bill you can’t pay without endangering your family finances, call them and ask about financial assistance.
If you want to see what you qualify for and how much it will cost, there is a Plan Finder on the Connect for Health Colorado website that you can use anonymously. You enter the ages of the people in your household needing coverage and an estimate of your gross income after a few deductions, and you get an estimate of what kind of discount and which plans you might qualify for. You can then go in and “window shop” for plans so you get a sense of what’s available.
In Colorado, Medicaid has been expanded, and it’s called Health First Colorado. Click on the link for more information about Medicaid, CHP+ (which is a subsidized health plan for children under 18), and how Connect for Health Colorado works. To sign up for Medicaid, you have to go through the Connect for Health Colorado process. However, if you know you are applying for Medicaid, going through the PEAK website as well will save you some hassles in the long run. You have to create two accounts, so be sure to record the user names and passwords somewhere you can find them. When I worked as a Health Coverage Guide helping people enroll, I spent more time getting people into their accounts (because they forgot their PEAK and Connect for Health passwords) than I did with anything else.
Let’s dig in to how to use the website and what the various terms mean. When you go into Connect for Health Colorado, the first thing you see is information about COVID-19. To find out how much you might have to pay, click under Financial Help and go to Estimate Your Savings, which takes you to the Plan Finder again. Whether you have gone all the way through the website, or are just doing the Plan Finder, here is what to look at.
On the left, you can filter by the amount of the monthly premium, annual deductible insurance companies, and coverage levels. Coverage levels are broken into Bronze, Silver, and Gold. No one needs Gold unless they have money to burn. Silver and Bronze can end up costing you more or less, depending on how much health care you use, how steady your income is, and how good you are at saving. Premium Tax Credits, if you qualify for them, only apply to Silver and Gold plans. If you need to use your health care a lot, then a Silver Plan might be the best deal for you.
The various terms can be confusing, and they intersect. Here’s a cheat sheet.
Deductible: The maximum amount you have to pay for health care (excluding the preventative care that is still included in your insurance under Obamacare) before your health insurance kicks in. Annual Out-of-Pocket Maximum: The amount you have to pay for yourself, including before deductibles and copays, before health insurance covers 100% of what is included in the plan. This does not include what you pay for premiums. Yearly Cost Estimate: A guess of what it will cost you per year, including your monthly premiums and your out-of-pocket expenses.
If you are getting insurance because you don’t want to go bankrupt if you get COVID-19, didn’t get enough of a Premium Tax Credit, don’t have a lot of money, and don’t go to the doctor a lot, then you might want to consider a Bronze plan–and start a savings account on your own if you can. It has a higher deductible, and a higher out-of-pocket maximum than a Silver, but because your monthly premium is lower, you end up paying less during the year. When this was my job, I had a whole graph that allowed us to compare plans depending on usage of health care to figure out which plan was actually cheapest. I wish I could tell you it’s obvious, but it’s not.
If you are confused by the process, Boulder County Health Coverage Guides are the best in the state. Email them at firstname.lastname@example.org. Tell them whether you would want to meet in Boulder or Longmont, and give them some days and tell them mornings or afternoons. I am sure they are very busy right now, so the more times you give them, the better. I do not recommend calling–you will most likely be on hold for a very long time and it will just be to make an appointment anyway.
You can also call Connect for Health Colorado at 855-752-6749, or you can try Live Chat with them.
Gather your Colorado ID(s) and your paystubs and go through the website and answer the questions to the best of your ability. Because of COVID-19 and so much job loss, Connect For Health has changed the website to ask about expected income for 2020. That can be hard to estimate, because we still don’t know how long we will be staying at home and how bad the recession will be, but do your best. That estimate is better than what was always used in the past, which was the previous year’s income.
Connect for Health has an agreement with the state Division of Employment, so they know how much you earned and the last date you got paid. If you are self-employed or an independent contractor or have rental income, you will need to have estimates of the actual numbers you would put into your Schedule C, so have those numbers figured out before you go in. If you underestimate how much you will make, you may have to pay back part of the Premium Tax Credit. Conversely, if you overestimate, you can get a refund. Both require a special form when you pay your 2020 taxes.
Good luck! For most people who recently had a paycheck, the website is fairly quick and easy.