Although CKF does not provide health insurance, we can help you learn about your options.
There are two low cost or free public health insurance options available in Colorado: Medicaid and Child Health Plan Plus (CHP+). These are options for Coloradans with low incomes and/or disabilities. Like private health insurance, both Medicaid and CHP+ provide coverage for medical care at participating providers. Coverage for dental care may also be included.
Connect for Health Colorado is an option for individuals and families to shop for private health insurance coverage. By shopping through Connect for Health Colorado, individuals and families within certain income ranges may qualify to receive federal tax credits to reduce the cost of their health insurance premium, and the cost of co-payments.
Individuals and families can also shop for full-cost health insurance outside of the options listed above.
What is Medicaid?
Medicaid provides health insurance coverage to low-income children, families, pregnant women and adults, and to people living with disabilities. There are many different Medicaid programs and the rules are different for each one. However, individuals or families can typically qualify for Medicaid if their family has a combined income below certain thresholds based on the Federal Poverty Level (FPL). For people without disabilities, Medicaid typically provides coverage based on four categories with the following income ranges:
- Children (ages 0-18) in families that earn up to 142% of the Federal Poverty Level (FPL) – up to $2,876/month for a family of four.
- Pregnant women (ages 19+) in families that earn up to 195% FPL – up to $3,949 for a family of four.
- Parents and Caretaker Relatives (ages 19-64) of Medicaid eligible children in families that earn up to 68% FPL – up to $1,377/month for a family of four.
- Adults (ages 19-64) including parents and caretaker relatives, that earn up to 133% FPL – up to $1,294/month for an individual or $2,688/month for a family of four.
The Colorado Department of Health Care Policy and Financing administers the Medicaid program in Colorado. Visit their website to learn more about Medicaid, including Medicaid income guidelines, and Medicaid benefits.
For many Medicaid programs, income is calculated using a formula called Modified Adjusted Gross Income or MAGI, which is similar to what people report on their taxes with some modifications. You must apply to find out if your family is eligible. The income guidelines listed above are for reference only, and you or your family may qualify even if your income is higher than what is listed above. You can apply for Medicaid at any time.
What is CHP+?
CHP+ stands for Child Health Plan Plus, and it provides health insurance coverage to children and pregnant women in low-income families who earn too much to qualify for Medicaid. The income limit for CHP+ is 260% FPL in Colorado. Generally, CHP+ provides coverage for the following people:
- Children (ages 0-18) whose families make too much to qualify for Medicaid but who earn between 143 to 260 percent FPL – up to $5,255/month for a family of four.
- Pregnant women (ages 19+) who earn between 186 to 260 percent FPL – up to $5,255/month for a family of four.
The Colorado Department of Health Care Policy and Financing administers the CHP+ program in Colorado. Visit their website and the CHP+ website to learn more about CHP+, CHP+ income guidelines, and benefits.
To qualify for CHP+, the state calculates family income using a formula called Modified Adjusted Gross Income or MAGI, which is similar to what people report on their taxes with some modifications and standard deductions. You must apply to find out if your family is eligible. The income guidelines listed above are for reference only, and you or your family may qualify even if you make more than the income guidelines listed above. You can apply for CHP+ at any time.
Unlike Medicaid, CHP+ does require the family to pay an annual enrollment fee before the child is enrolled in coverage. The fee depends on the family income and how many children are enrolling. Payment can be made online, in person, or by mail. Learn more about CHP+ fees and co-payments.
What is Connect for Health Colorado?
Connect for Health Colorado is an online health insurance marketplace where individuals, families, and employers can shop for and compare private health insurance plans. Although families can purchase private health insurance elsewhere, Connect for Health Colorado is the only place where individuals and families can receive federal tax credits to reduce the cost of health insurance. Families may qualify for tax credits or other cost reductions if their family income is between 100 to 400 percent FPL – up to $95,400/year for a family of four.
You can enroll in private health insurance only during enrollment periods. There is an open enrollment period when anyone can apply and enroll in private health insurance. The open enrollment period for 2016 coverage has ended. If you do not enroll in private health insurance by the end of open enrollment, you may have to go without coverage unless you have a qualifying life event. A qualifying life event allows and individual or family to apply and enroll in private health insurance during a special enrollment period.
Learn more about how to shop for health insurance, and how to use health insurance from the Colorado Consumer Health Initiative’s CoveredU.
How do I apply?
There is combined application for Medicaid, CHP+, and tax credits through Connect for Health Colorado.
You can apply through any of the following methods:
- Online: Visit Colorado PEAK or Connect for Health Colorado to apply online. Both websites will ask the same information, and will determine if you are eligible for Medicaid, CHP+, or reduced costs through Connect for Health Colorado. The online application can also be used to upload documents. After applying online, many people receive an immediate determination. Note that if you would like to apply for other assistance programs like the Supplemental Nutrition Assistance Program (formerly known as food stamps) or financial assistance at the same time that you apply for medical assistance, you can complete all applications through Colorado PEAK.
- In person: Several options are available if you would like help applying in person:
- Local County Department of Human Services – These offices are best for people who will be eligible for Medicaid or CHP+, and/or who also want to apply or manage other programs like food or financial assistance.
- Certified Application Assistance Sites – These local organizations can help you fill out the application, submit documents, and answer questions about Medicaid and CHP+
- Presumptive Eligibility Sites – These local organizations can help eligible children and pregnant women receive a card that gives them temporary Medicaid or CHP+ coverage while their application is being processed.
- Connect for Health Colorado In-Person Help – These local organizations can help you fill out the application, submit documents, and answer questions about Connect for Health Colorado.
- Community Health Centers – Many local community health centers have staff that can help you apply for Medicaid, CHP+, or Connect for Health Colorado
- By Phone:Call the state Medicaid and CHP+ customer service line at 1-800-221-3943, or the Connect for Health Colorado customer service line at 1-855-PLANS-4-YOU
- By Mail/Paper: The paper application is available in English or Spanish. (You must have Adobe Acrobat to view and print the application. Click here if you need to download Adobe Acrobat.) Call the Medicaid and CHP+ customer services line at 1-800-221-3943 to have a paper application mailed to you.
Problems Getting Your Medicaid or CHP+ Benefits?
If you applied for Medicaid or CHP+ and have not heard about your benefits, here are some things you can do to help your application:
- Check your application status.You can check your application status online through Colorado PEAK, or you can call 1-800-359-1991.
- Make sure that your application is complete.After checking the status of your application, you may find out that additional information is needed to process your application. Follow the instructions in your Colorado PEAK account to provide the needed additional information. You should also receive a paper notification in the mail if more information is required, or you can talk to your case worker (the person who is processing your application at the county, Denver Health, CHP+, or Connect for Health Colorado) to make sure that you filled out your application right and sent in the necessary documentation.
- Wait 45 days. Counties, Denver Health, and CHP+ have 45 days to process a complete application. If you haven’t heard about your application within 45 days:
- Call your caseworker to check on the status of your application.
- Call the Medicaid Customer Service Information Line:1-800-221-3943
My eligibility is approved. What’s next?
Watch your mail for important information– you should receive your Medicaid card, benefit letters, notices for additional information, your enrollment packet, and information about renewing your coverage in the mail.
Choose a health plan within 90 days– a health plan is a set of doctors that help you use your Medicaid benefits. Review the Medicaid Health Options comparison chart, then call HealthColorado to let them know your health plan selection: 1-888-367-6557
Find a doctor– you can search for a Medicaid doctor, or if you are a member of the Accountable Care Collaborative health plan, you can ask for help from your Regional Care Collaborative Organization.
Stay covered– adults should report any changes to their family size or income through the PEAK website within 10 days. Changes to family size or income may impact http://www.cialisgeneriquefr24.com/cialis-forum-doctissimo/ your eligibility. If you think you may lose Medicaid coverage because of a change in income or family size, you can stay covered by applying for private coverage through Connect for Health Colorado. Remember that children (ages 0 – 18) will stay enrolled in Medicaid for 12 months regardless of changes to income or family size.
Pay the CHP+ enrollment fee– After a child is determined eligible for CHP+, she is not enrolled until her parent pays the CHP+ enrollment fee. The fee can be paid online through Colorado PEAK, in person, or by mail.
Watch your mail for important information– You should receive your CHP+ membership card, benefit letters, notices for additional information, your enrollment packet from your CHP+ HMO, and information about renewing your coverage by mail.
Choose a CHP+ Health Maintenance Organization (HMO) or keep the one you have– Children are automatically enrolled in a CHP+ HMO after they enroll, however clients have to opportunity to select a different HMO if they choose to. Review the CHP+ HMO comparison chart, then call CHP+ Customer Service at 1-800-359-1991 to select a different HMO. Pregnant women enrolled in CHP+ will be enrolled in the State Managed Care
Find a doctor– Contact your CHP+ HMO for help finding a doctor that will accept CHP+.
Stay covered– pregnant women with CHP+ will become ineligible 60 days after she is no longer pregnant. She may be eligible for tax credits to lower the cost of private health insurance through Connect for Health Colorado. She can report the end of pregnancy through PEAK, and receive a new eligibility determination. Children (ages 0-18) will stay enrolled in CHP+ for 12 month regardless of changes to income or family size.
Connect for Health Colorado
Research health plans and make a selection– Once you find out that you qualify for Advanced Premium Tax Credits or Cost Sharing Reductions, you can research plans on the Connect for Health Colorado website. Pay attention to cost, participating doctors, prescriptions coverage, and the coverage level.
Pay the premium– in order to finalize your insurance, you need to pay the first month’s premium directly to the insurance provider.
Find a doctor– contact your insurance provider to find out more about participating doctors.
Stay covered– keep your coverage by continuing to pay your part of the monthly premium, and taking action annually to renew your coverage or select a new plan. If your household size or income changes, you may qualify for other programs including Medicaid or CHP+. You can report a change to your income or family size to Connect for Health Colorado to see if you qualify for a different program.
Options for the Uninsured