Colorado Health Care Reform
Guaranteed Acceptance & Pre-Existing Conditions
One of the biggest changes in health care under the Affordable Care Act (ACA) is guaranteed acceptance of pre-existing conditions. Insurance companies can no longer deny coverage to applicants with health conditions excluded in the past.
While guaranteed coverage provides welcome relief to Coloradans who have had difficulty finding accessible, affordable health insurance coverage for pre-existing conditions like cancer, diabetes, heart disease and others, the all-inclusive ACA mandate is resulting in higher premiums across the board.
Insurance consumers, who previously stayed in jobs solely for the health coverage, are now able to review their options in the individual market without hesitation based on a health issue.
Guaranteed Acceptance and Existing Plans
If you have a grandfathered plan that is terminating once you are outside the open enrollment period, you can qualify for a Special Enrollment Period during which time you can enroll in an ACA-qualified plan with guaranteed acceptance of pre-existing conditions.
Special Enrollment Periods
If you are outside the open enrollment period, a qualifying life-event (including change in marital status, dependent status, birth or adoption of a child) can open a special enrollment period for 30 days after the event. If you are turning 26 (when you are no longer allowed coverage on a parent’s plan), you can take advantage of the special enrollment period for 30 days to buy an individual ACA-qualified plan.
Special circumstances such as a significant decrease in income, financial hardship, or new unemployment benefit claims can be addressed during special enrollment periods as well. A change in income can also change your eligibility for premium tax credits. These issues can be addressed during special enrollment periods as well.
You must have health insurance for 10 months out of the year or face a tax penalty. Even if you qualify for a premium tax credit (subsidy), you must keep your policy in effect through continued premium payments each month to avoid the penalty.
You may qualify for a hardship exemption (including inability to afford ACA coverage after cancellation of non-ACA plan). Read more about hardship exemptions.
Short-Term Medical Plans
If you are looking to bridge the gap until your new policy takes effect in January, February or March of 2017, consider signing up for a short-term plan. A short-term plan provides solid, affordable coverage for up to 6 months in Colorado. Read more about short-term plans.
If you don’t enroll for a permanent health plan by January 31, 2017 or miss the January 31, 2017 application deadline, short-term plans are available throughout the year. Although they do not meet ACA standards and you may have to pay a tax penalty, you will still have solid insurance coverage should an unexpected medical situation arise.
ColoHealth is Certified on the Connect for Health Colorado Exchange
ColoHealth ’s team of Personal Benefits Consultants is backed by 25 years of insurance expertise. We are also certified as an authorized agent on the Connect for Health Colorado marketplace. When you authorize us as your agent on the Colorado exchange, we can help you with every step of your enrollment, premium subsidy application and more. Our services to you are always free of charge!
Our Annual Comprehensive Policy Review can help you make sure you’re staying with the plan that offers the best value, year after year.
ColoHealth can also show you how to combine your health insurance plan with a health savings account (HSA) to maximize your savings in several ways. When you open a tax-favored HSA, and are able to contribute the maximum allowable amount each year, you can:
- Reduce your taxable income
- Pay less income tax
- Increase your health care budget
- Improve eligibility for health tax credits
- Roll funds over annually for medical bills
- Withdraw medical funds without penalty
- Access total savings tax-free at age 65
Call ColoHealth today at (800) 913-6381 to speak with your Personal Benefits Consultant and find the coverage that’s right for you. You can also email us at info@ColoHealth.com with any and all questions.