Residents of the Centennial State are in luck when it comes to health care. According to a study by U.S. News, Colorado has the ninth best health care in the nation. That ranking accounts for access, quality, and good public health.
Health insurance options in Colorado
According to the CO Division of Insurance, there are several ways for state residents to get medical coverage.
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Colorado residents get their health care coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 52% | ||
| Individual or family | 7% | ||
| Medicaid | 18% | ||
| Medicare | 12% | ||
| Military | 2% | ||
| Uninsured | 8% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
8 percent of CO residents are uninsured, less than the national average. That can be a setback for policyholders. Higher rates of uninsured people raises premiums for insured people.
Colorado health insurance costs and rate factors
CO residents spend an average of $6,804 every year on health care expenditures. That’s a few thousand dollars less than the rest of the nation. How much should you expect to pay in monthly premiums in Colorado? Rates vary person to person based primarily on these factors:
Health insurance plan type
A big factor in your monthly costs is the level of coverage you want. More coverage costs more money. Marketplace plans come in metal tiers: bronze, silver, gold, and platinum.
How much is health insurance in CO? These are the average monthly premiums for a middle-aged resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $280 | $353 | $385 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
In Colorado, premiums for a gold plan cost about 38 percent more than for a bronze plan. This makes sense when you factor in that gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent. But health insurance costs have gone down in Colorado: an average gold plan costs $540 a month in 2018, but in 2020 costs only $385 a month.
If you are under 30 or have other exemptions, you may qualify for a catastrophic plan. Catastrophic plans offer the lowest level of coverage available. They have low monthly premiums but a yearly deductible of $8,150. Because of that deductible, having a bronze or silver plan may save you money when you need to use your insurance.
Body mass index
A high body mass can lead to several serious health conditions. That’s why insurance companies analyze your BMI to determine your risk-level. People with higher BMIs tend to pay more for health care.
In 2018, CO had a 23 percent obesity rate, the lowest in the country. Of the many state residents who used QuoteWizard to shop for health insurance, 22 percent have a BMI in the obese range.
Tobacco use
It’s no surprise that smokers pay more for health insurance because of the serious health conditions it causes. About 14.6 percent of Colorado residents are smokers, the 12th lowest rate in the country.
Age
Older people tend to pay up to three times more for health insurance than younger people. CO residents who used QuoteWizard to compare insurance policies are, on average, 39 years old.
Location
A big factor in your monthly costs is where you live. That’s because every state has different rules, regulations, and providers surrounding the marketplace. Even at a state level, health care options vary between counties.
Also, health insurance rates are often community rated. That means that rates are partly based on the combined claims everyone files. So, if your neighbor files an abnormally high number of claims, your prices could jump.
The health of residents in your state also plays a role. According to America’s Health Rankings, Colorado is the seventh healthiest state in the nation.
Colorado health insurance companies
- Anthem BlueCross BlueShield
- Bright Health
- Cigna
- Friday
- Denver Health
- Kaiser Permanente
- Rocky Mountain Health
- Oscar
Where should you turn to for a health care plan in Colorado? These are the top insurers offering individual and family plans in your state:
Anthem BlueCross BlueShield
Anthem BlueCross BlueShield offers a handful of member benefits. For example, one tool allows you to speak to a doctor 24/7. Plan options depend on your CO zip code, and prices vary based on your plan level. Either way, Anthem has a system to determine the plan that fits your lifestyle best.
Anthem is “dedicated to delivering better care to [their] members, providing greater value to [their] customers and helping improve the health of [their] communities.”
Bright Health
Bright Health offers several plan options for Coloradans. 2020 plans include gold, silver, silver plus, bronze, bronze plus, and catastrophic. Deductibles range from $2,000 for individuals and $4,000 for families to $7,350 for individuals and $14,700 for families. Some plans have higher deductibles and low monthly premiums, and vice versa. Bright Health has Care Partner health systems that cater to members. Many of those providers offer 24/7 nurse lines, after-hours and same-day appointments, no referrals, and more.
The company focuses on five values: be purposeful, authentic, brave, positive, and respectful. Bright Health’s vision is “collaborating with Care Partners to make healthcare simpler, personal and more affordable.”
Cigna
Cigna is a global health company that offers service to CO residents. The plans available to you depend on your zip code. Cigna offers bronze, silver, and gold level plans. These plan types cover 60 percent (bronze), 70 percent (silver), and 80 percent (gold) of medical costs. Cigna also has online health and wellness resources for topics like nutrition, exercise, family care, and more.
Cigna serves over 95 million customers around the world and employs more than 40,000 people. Their mission is to “improve [their] customers’ health, well-being, and sense of security with the power of preventive care.”
Friday Health Plans
Friday Health Plans offers four different health plan levels. These plan levels are: Kat (catastrophic), Brad (bronze), Silvia (silver), and Gordon (gold). Each plan offers three free primary care doctor visits per year. Deductibles for individuals range from $1,750 to $7,900. Family plans have double that deductible. The type of plan you should get depends on how often you expect to see a doctor. For example, a gold plan is better if you plan to be at the doctor more. A bronze plan is recommended if you just need the basics.
Friday Health Plans offers coverage across northern CO, Denver, and southern CO. The company is based in Denver and aims to offer low prices to make health care more affordable. The Friday Health Plans brand started offering plans in 2018.
Denver Health Medical Plan
Denver Health Medical Plan offers several benefits to members. Benefits include health coaching, which matches you with a coach to help you stop smoking, start an exercise program, and more. Also, members can participate in classes to learn about weight management, depression, diabetes control, and more. The organization offers plans at the bronze level, silver level, and gold level. Each metal tier covers a percentage of medical costs and determine your premiums and deductibles.
Denver Health Medical Plan was created in 1997 that serves over 27,000 Denver area members. Their mission is to “provide affordable, high quality healthcare coverage for all, in partnership with Denver Health.”
Kaiser Permanente
Kaiser Permanente serves the Denver/Boulder area, the mountain area, northern CO, and southern CO. The company has more than 30 medical offices, plus an extensive network of doctors and specialists. Members have these benefits: health classes, wellness coaching, healthy lifestyle programs, and more. The plans available to you depend on the county you live in. There are also several provider options in each area. For example, there are more than 400 Kaiser Permanente doctors in the Northern CO area alone.
Kaiser Permanente was founded in 1945 and now serves 11.8 million members across the US. The company’s mission is “to provide high-quality, affordable health care services and to improve the health of [their] members and the communities [they] serve.”
Rocky Mountain Health Plans
Rocky Mountain Health Plans are categorized into metal tiers: bronze, silver, and gold. The metal levels cover 60, 70, and 80 percent of medical costs. Plans fully cover these services: immunizations, children’s services, routine screenings, and more. Plans include benefits like discounted gym memberships and an online doctor chat tool.
Founded over 40 years ago, Rocky Mountain Health Plans aims to provide members with personalized and quality care. As a CO company, Rocky Mountain Health Plans prides themselves on keeping Coloradans healthy.
Oscar
Oscar began offering health insurance through Colorado's marketplace in 2020. They sell Bronze, Silver and Gold plans throughout Colorado. The New York-based insurer states they were the first provider to offer 24/7 telemedicine to policyholders. The company prides itself on integrating digital tools for increased simplicity in a complex industry.
You can find out more about these policies through the state’s health care marketplace.
Colorado health insurance laws
The Affordable Care Act limits insurance companies from restricting coverage or unfairly charging higher rates.
- Pre-existing conditions: According to healthcare.gov, insurance companies can no longer charge you more for pre-existing conditions. People with pre-existing conditions used to pay more for health insurance.
- Gender: Women have historically paid more for health insurance. But the ACA now mandates that men and women can’t be charged different prices for the same policy.
- Insurance and medical history: The ACA also used to analyze your prior insurance coverage and medical history. Now, the ACA limits providers from considering these factors.
There’s a limit to how much you’ll pay out-of-pocket for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
Colorado state law requires health insurance companies to offer at least some coverage for the following services:
- Mental illness
- Clinical trials and studies
- Diabetes
- Contraception
- Maternity coverage
- Hearing aids for children
- Prosthetic devices
There are additional services that insurers need to provide. You can find the full list on cms.gov.
Medicare and Medicaid in Colorado
Medicare and Medicaid are both government-funded health care programs that help Americans get affordable health care. Medicare targets seniors, while Medicaid assists low-income families and children.
Medicare
Medicare is a program aimed at residents 65 and older. There are plenty of coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Programs with these income limits:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
Nationally, the number of uninsured Americans has improved considerably since the Affordable Care Act (ACA) passed in 2010. Medicaid expansion was vital in reducing Colorado’s uninsured rate.
In 2013, 13.9% of Colorado’s residents did not have medical insurance. In 2014, Colorado expanded its Medicaid program in 2014, and by 2019 the state’s uninsured rate dropped by 20.8%. One reason was a 6.1% increase — or 54,000 Colorado residents — in Medicaid enrollment from 2014 to 2019.
Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements for adults:
| Household size | Maximum monthly income |
|---|---|
| 1 | $1,415 |
| 2 | $1,911 |
| 3 | $2,408 |
| 4 | $2,904 |
| 5 | $3,401 |
| 6 | $3,897 |
| 7 | $4,394 |
| 8 | $4,890 |
Note that income limis are different for children, parents and pregnant women.
Colorado Division of Insurance
- Website:
- Homepage
- Insurance Commissioner:
- Michael Conway
- Insurance Hotline:
- (800) 830 - 3745
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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