How to Apply for Coverage on the Connect for Health Colorado Marketplace
How to Apply for a Health Insurance Plan and Advance Premium Tax Credits on the Connect for Health Colorado
Colohealth Personal Benefits Managers are certified by the Connect for Health Colorado marketplace to help you to purchase your plan and apply for advance premium tax credits. We can help you to understand what pitfalls to watch out for. We’re here to help you find the plan that’s right for your unique needs and budget!
ALERT! Don’t Skip the Most Important Part of the Connect for Health Colorado Process!
You must authorize Colohealth as your agent after you create your profile in order to get the help you need — whether you are applying for an advance premium tax credit or simply browsing plans for enrollment. Get the simple, yet critical, steps here.
Getting Started: Determine Your Household Size
Depending on the size of your household and its income level, you may be eligible for Medicaid or for special federal subsidies called advance premium tax credits. These are determined by the size of your household and your household’s estimated income for the upcoming year. When determining your household size, count yourself, your spouse or unmarried partner needing insurance, and any children who live with you (even if they make enough money to file a tax return themselves).
Estimating Your Income for the Upcoming Year
Next, determine your household income. This includes total income for all people living in your household, including income earned by any dependents in your household who earn enough to file a tax return. Keep in mind that married couples must file jointly in order to qualify for an advance premium tax credit. The federal government uses your modified adjusted gross income (MAGI) for purposes of calculating premium tax credits. For most people, their MAGI is similar to their adjusted gross income (AGI). Remember to try to be as accurate as possible, as there will be a reconciliation of the advance premium tax credit when you file your income taxes in the following year.
Some people, especially those who are self-employed, may find it difficult to accurately estimate their income. Income can wind up being higher or lower than estimated, and if that happens you’ll need to call the Connect for Health Colorado customer service line at the end of the year to have your premium subsidy adjusted.
Figuring Out Advance Premium Tax Credit Eligibility
Once you’ve determined your household size and income, you’re ready to determine if you are eligible for Medicaid or premium tax credits. Every year the Center for Health and Human Services determines what the Federal Poverty Limit (FPL) will be for the upcoming year. You can find a table listing the FPL for individuals and families here, on the federal government’s healthcare website.
If your income is below 133 percent of the federal poverty level (FPL), you qualify for Medicaid. As a results of the ACA the eligibility requirements for Medicaid have broadened as far as who qualifies.
If your income is between 133 and 400 percent of the FPL, you’ll qualify for a premium tax credit. If your income is between 133 and 250 percent of the FPL, you are also eligible to apply for a cost-sharing tax credit (for ACA Silver plans only).
If your income is above 400 percent of the FPL, you will not be eligible for a premium subsidy tax credit, but you can still use the Connect for Health Colorado marketplace website to get your insurance plan. If this is your situation, you can skip the advance tax credit application page and go directly to choosing the health plan you like.
The Connect for Health Colorado marketplace exchange is the only place you can get an advance premium tax credit. But you can get a health insurance plan without applying for the subsidy if you don’t qualify or don’t want to apply now for a tax credit.
Get Started With Your Application
The next step is to complete your eligibility for an advance premium tax credit. This process is required if you think you may qualify for Medicaid or a premium tax credit.
You can skip this step if you think you won’t qualify for a premium tax credit or Medicaid assistance or if you don’t want to go through the process of applying for the advance premium tax credit at this time.
If you want to skip this step (which takes about an hour to complete), you can still apply for a health plan and apply for the tax credit subsidy when you file your taxes.
Note that if you apply for an advance premium credit now, you’ll immediately get the reduced rate for your monthly premiums if you qualify.
Applying for an Advance Premium Tax Credit
Log in to your account profile and select the “agree to privacy” button. This will take you to the “Do I qualify for financial assistance?” page. When visiting this page for the first time, you have not been denied for Medicaid or CHP Plus , and need to select the “No” button under “Have you been denied for Medicaid?” to continue to the PEAK system.
You’ll then create a new account and apply for Medicaid. Whether or not you qualify for Medicaid, you have to complete this step to get to the advance premium tax credit application.
Get Your Medicaid Denial Number
This step takes about an hour. 80 percent of applicants will get a denial the same day, while others will get a denial in a couple of days. The site will warn you that it could take up to 45 days. The denial, which is a seven-digit Medicaid denial code, will be used when you go back to apply for your advance premium tax credit. When you get your seven-digit Medicaid denial code number, you’ll go back to your account page and go through the “Do I qualify” process again. This time, answer “yes” and enter your seven-digit denial number. Go on to complete the eligibility application for advance premium tax credit. This takes about 20 minutes. At the conclusion, you can browse insurance plans to see the net cost minus your approved advance premium tax credit.
Here’s an example: If a plan costs $400 per month and your advance premium tax credit is $100 per month, your net cost will be $300 per month for your premium. Don’t forget to look at the “Silver” plans to see if you qualify for a cost-sharing subsidy; this will give you lower deductibles and out-of-pocket maximum costs when your household income is between 133 and 250 percent of the FPL.
How to Browse Plans
✓ Start your search for a plan by clicking on “Find a Plan” and then select “Click here to Browse health plans.”
✓ Click “Browse Plans.”
✓ The system will “default” to show the lowest-priced plans with the highest deductibles.
✓ Filters on the left side let you sort plans by monthly premium, deductibles, out-of-pocket maximums and insurance carrier.
✓ The Metro Denver list is larger than other areas in Colorado.
The quality of benefits and costs vary by the metal plans of Platinum, Gold, Silver and Bronze, with premiums increasing in cost from Bronze (lowest) to Platinum (highest); deductible amounts, copays and out-of-pocket expenses will also vary based on metal plan.
Check Your Provider’s Network Status
Although the names of insurance carriers may be familiar to you, you should not assume that the provider networks for these are the same as you’ve experienced previously. Many networks on the marketplace are smaller than in the past.
You can use the “doctor look-up” feature to see if your preferred doctor is in the network for the plan you’re considering.
Just choose the doctor by last name, zip code and mile radius to see the name you’re looking for. Select your doctor and you will see what network he or she is connected to by returning to “plans.” The system should filter in the provider networks associated with this doctor.
Comparing Plans
When comparing annual premium costs, keep in mind that “Bronze” plans have a maximum on their costs, including deductibles and copays per year.
You can apply a filter for “Silver” plans. Look at deductibles as well as maximum annual costs. Select boxes to compare up to three plan options side by side.
You can compare monthly premiums, deductibles, out-of-pocket maximums, copayments, and prescription drug coverage for generic or brand drugs. You should review these costs for any plan you are considering so that you are not surprised with an unexpected bill after going to the doctor.
Also check out facilities and coverage for inpatient surgery or outpatient services. Some have copayments for urgent care on nights and weekends.
When you’re ready to purchase a plan, add it to your cart and check out.
Work With Your Certified Colohealth Personal Benefits Manager
We encourage you to work with your Colohealth Personal Benefits Manager to avoid any pitfalls or mistakes in the enrollment process that could cause delays or added expense later on. It’s easy to protect yourself with our expertise with a few simple authorization steps!
Our Colohealth Personal Benefits Managers are ready to help you find the plan that’s right for you and your family. Call us today at (800) 913-6381!
Health Insurance Instant Quote
HEALTH INSURANCE INFORMATION
- Plans approved and authorized under the Affordable Care Act
- Covers Pre-Existing conditions
- Low cost subsidized plans available to those earning
< 400% of the federal poverty level - Unlimited lifetime benefits
- Available during open enrollment (November 1 – January 15), or if you qualify for a Special Enrollment Period
How to Choose an HSA-Qualified Health Plan
HSA plans are simple and easy to understand. If you need some basic information on how Health Savings Accounts (HSAs) work, visit our HSA page.
A relatively small percentage of health insurance plans are HSA-eligibile. If you are looking at health insurance quotes through our quote engine, HSA plans will be noted.
While HSAs are typically associated with insurance plans, ColoHealth also offers a partially self-directed HSA combined with a healthshare program through MPowering Benefits. Health care sharing programs are not insurance; instead, they pay formedical expenses in a different way. Members pay monthly contributions, and that money is pooled together to pay for its members’ qualifying medical expenses.
Health share programs offer significant savings, one of their biggest appeals and one of the reasons why there are now more than a million people who have joined a health share program. However, they aren’t for everyone. If you have a pre-existing condition or are currently going to the doctor often, medicare cost sharing programs might not be the right fit for you.
When you are ready to choose a plan, follow the directions below. It usually takes no more than 10 minutes or so to choose the best plan for your needs.
1. Get an Instant Quote.
Our instant quote engine can rapidly show you the available plans in your area, so that you can get an overall feel of what premiums will be for the different HSA plans.
To see just the HSA health insurance plans, change the “Plan Type” on the Customize Search tab at the top of the page to “HSA”. Note that not all insurance companies and plans are available in all areas.
The healthshare program that works with an HSA is very attractively-priced, particularly if you do not qualify for a health insurance subsidy.
Get an Instant HSA Health Insurance Quote
Get an Instant HSA Healthshare Quote
2. Compare premiums/monthly contribution amounts.
This will quickly give you a feel for which companies are most competitive in your area.
3. You may want to consider adding an $100 deductible accident policy. Stand-alone accident plans can be viewed on our Accident Plans page. Because these accident plans are very inexpensive, you may be able to keep your premiums lower while greatly reducing your exposure for the type of claim you’re most likely to need your health insurance for – an accident.
4. With both health insurance and most health sharing plans you may want to check the insurance company’s PPO or HMO network to see which doctors and hospitals are considered in-network providers. The link to each plan’s PPO or HMO network can be found on that company’s page on our site.
Note that some healthshare programs do not use a network, and allow you to see any doctor of your choice.
How to Apply for Coverage
Applying for HSA health insurance and establishing an HSA is quick and easy. Most companies allow you to apply online. Or you may simply print out an application and fax it to us at 866-284-0082, or mail in your application to the address below.
Apply Online
The easiest and most efficient way to apply for an HSA plan is online through a secure online application. This will enable you to avoid the hassles of filling out a paper application and will speed up the process by instantly transmitting your information directly to the insurance company. The application usually takes about 10 minutes to complete.
You may apply online by running instant quotes, and apply online for most plans we offer right from the quoting system's results page. Or simply select the apply online link below for the plan you are interested in.
If you are interested in a healthshare plan, you can get a quote on the MPowering Benefits HSA-qualified health share plan, and apply online.
Mail or Fax an Application
You can download an application for the plan you are interested in, print it out, fill in all the required information, and then either fax it to us toll-free at (866) 284-0082 or mail it to us at the address below.
What Happens After You Apply
When you apply for a health insurance plan through Colohealth, we immediately submit the information. We monitor your application during the whole process, and keep you informed. We use our experience and connections to make sure your policy gets issued as quickly as possible. If any additional information is needed, we’ll let you know. We will inform you as soon as you’ve been approved, and make sure you’re happy with your coverage.
We're Here to Help
As you've probably noticed, our website is comprehensive and should answer most of your questions. However, if you need personal assistance, we are happy to help. Simply pick up the phone and call us, or if you are already in communication with one of our Personal Benefit Managers, you can contact them directly.
If you’re unsure, you may want to schedule a telephone consultation before you sign up for a plan. We will help you fully analyze all your options, let you know the pros and cons of the various plans you are considering, and give you our professional opinion about which plans will best meet your needs. We’ll then help you get enrolled with the plan you choose.
How to Establish Your Health Savings Account
Once you have applied, you'll want to go ahead and set up your Health Savings Account. You are not required to establish an HSA, but by funding the account as soon as possible you'll be able to take advantage of the tax deductions and tax-deferred growth HSAs offer.
To establish your HSA, follow the steps below:
- Choose the bank or trustee you would like to administer your HSA.
- Fund your account no later than April 15th for the previous year.
- Decide how you want that money invested.
- Decide on a strategy for when you’re going to make withdrawals (see the How to Maximize Your Tax Benefits section below).
How to Maximize Your Tax Benefits
An HSA plan is really a pretty simple concept. You have a high-deductible health insurance plan you hope to never use, but if something big does happen, it will protect your assets and cover your medical expenses. There are a few things that can make a big difference in how much money you spend and how much money you accumulate in your account.
There are basically three different strategies on how to fund your HSA.
- Put no money in the account, except when you incur a medical expense. This strategy allows you to legally "launder" any money used to pay medical expenses. In other words, by depositing money into your HSA, then immediately withdrawing it to reimburse yourself for medical expenses, you are making your medical expenses all tax-deductible. You may want to use this strategy if you are on a tight budget and want to keep your cash outlay as low as possible.
- Fully fund the account, or at least put in as much as possible based on your budget. Take money out of the account any time medical expenses are incurred, and let the rest grow tax-deferred. This strategy will maximize your tax deduction, while making your HSA funds available to pay any non-covered medical expenses before your deductible is met.
- Fully fund the account, but pay all medical expenses from a non-HSA account. Reimburse yourself for medical expenses at a later date. This strategy will allow you to maximize your tax deduction and the tax-deferred growth of your HSA. You can then reimburse yourself, tax-free, at any time in the future for medical expenses incurred over the ensuing years.
To maximize the potential growth of your funds, you may want to make your HSA deposits as early in the year as possible. Any growth in your account is tax-deferred, like an IRA.
Take Full Advantage of Your HSA
Don't forget that every time you fund your account you get an instant tax deduction. When you offset the tax savings against your premiums, your net cost for an HSA plan can be very low.
The maximum allowable contribution goes up every year with the Consumer Price Index. If you are contributing to your account for 2024, the individual contribution limit is $4,150, and the family limit is $8,300. In 2025, that limit is $4,300 for individuals and $8,550 for families.
Review your options.
Rate increases for plans happen only in January, so make sure to review your options every year during open enrollment to make sure they’re still the best choice for you. Even if you switch to a plan without an HSA, the account and money are still yours to use; however, you simply can’t contribute to it anymore until you’re under another HSA-qualified plan
Often, people keep their plan much longer than they should, and end up paying much more than they should. If your rates go up, you can compare a wide variety of plans on our Instant Quote System. If you have your coverage through ColoHealth, we automatically do this analysis of available plans for you any time we are notified of rate increases.
Whether you pick an HSA with an insurance plan or a health share plan, HSAs plans are a great way to protect yourself while saving tax-deferred money. If you have any questions or would like to review your options, reach out to your Personal Benefits Manager or give us a call. We’d love to chat and help you through the process.
Healthshare Instant Quote
HEALTH COST-SHARING INFORMATION
- Not health insurance, but a way for like-minded individuals to share medical expenses
- Waiting periods on pre-existing conditions
- May exclude sharing for certain conditions or activities
- Enroll any time
- Much lower monthly cost than unsubsidized health insurance