Home to the Rocky Mountains, and therefore a massive center for ski resorts, mountain sports and natural living, Colorado is a healthy state to live in. There are many nature preserves, parks and wildlife areas, as well as rodeos and other Western cultural attractions. Residents of Colorado can enjoy a variety of activities in the cities of Denver, Colorado Springs and Boulder, as well as the many outdoor opportunities for all seasons. In Colorado, there are several strong health insurance companies to choose from, including Anthem Blue Cross Blue Shield of Colorado, Cigna, Humana, Kaiser Permanente, and UnitedHealthOne. To compare prices between companies and check which plans are available in your area, enter your zip code in the quote engine below. If needed, you can call one of our licensed Colorado agents any time for questions at 888 803 5917.
Colorado is one of the healthiest states in the U.S., earning 9th place for 2011 in the UnitedHealth Foundation health rankings. Some of the contributing factors to this rating include exceptional air quality, a low prevalence of diabetes and obesity, and an increasing amount of Colorado residents getting health insurance. The uninsured population rate is now at 13%, which is considerably lower than many other states. Colorado also has the lowest population of obese adults, though the number has increased over the past ten years. There is also a low number of preventable hospitalizations compared with the rest of the country.
Although many good health qualities remain among Colorado residents, there is still room for improvement when it comes to the increasing levels of obesity and diabetes. Binge drinking affects nearly 16% of all adults in Colorado, which is more than double the lowest amount in the U.S. Other positive notes for Colorado include some of the lowest rates of death due to cardiovascular illnesses as well as cancer. If individuals who live in Colorado keep pursuing a healthy lifestyle and continue to stay insured (and uninsured residents get themselves a health plan), there is a great chance that Colorado can remain one of the healthiest places to live in America.
Health Insurance Plans
Anthem Blue Cross Blue Shield of Colorado
- Premier plans from Anthem Colorado offer coverage on more medical services than any other Anthem plan, including unlimited doctor’s office visits for a copay as soon as your plan starts. More immediate benefits include preventive care, which is covered at 100% when you see an in-network provider. There are a variety of deductibles to choose from, ranging from $1,000 to $6,000 for individuals, and double the amount if you have any dependents. Once you have met the deductible, you can see an in-network provider for 25% coinsurance or an out-of-network provider for 50% coinsurance. Prescription drugs are available for a $15 copay for Tier 1, $40 for Tier 2, $60 for Tier 3 and 25% coinsurance for specialty.
- SmartSense plans in Colorado offer a basic level of coverage, including deductibles from $1,000 to $6,000 for individuals in-network. After the deductible has been met, you have a more limited amount of medical services available to you than other plans, though they are covered at 70%. Some of the covered services include maternity care, doctor’s office visits (after the first three for a $30 copay), diagnostic services, emergency and urgent care, inpatient hospital stays, outpatient care such as surgery and more. Preventive care with an in-network doctor is covered in full as soon as your plan starts, and all tiers of prescription drugs are covered.
- Lumenos HSA plans are high deductible plans with the option of opening a health savings account (HSA). These plans have deductibles of $3,000, $4,500 and $5,950 to choose from for individuals, and $3,500, $5,500, $7,500 or $11,900 for families. Once you have met the deductible, all major medical services with an Anthem provider are covered at 100%. Covered care includes doctor’s office visits, X-ray and lab work, outpatient services, inpatient stays, prescription drugs, maternity care and more. Preventive services are also covered in full, before meeting the deductible when using in-network doctors.
- Open Access plans from Cigna are PPOs, which mean you have the freedom of using network or non-network providers for your health care. When you use the Cigna preferred provider network, you will receive significant discounts on many types of medical care, with coverage of either 80% or 100% after deductible. Preventive care is covered in full from the start date of your plan, which includes vaccinations for children and adults, OB-GYN exams, annual physical exams and more. Primary care visits are available for a $30 copay as soon as your plan starts, in addition to specialist visits for a $50 copay.
- Open Access Value plans are also connected to the preferred network of Cigna providers. Based on the deductible you choose, these plans cover 70% or 100% of your medical care once you meet the deductible. Immediate benefits include visits to a physician, which will cost a $40 copay for non-specialists and $50 for specialists. After the deductible has been met, covered services include inpatient hospital stays, surgery in any setting, diagnostic testing, physical therapy and more. When using an in-network provider, preventive services are covered at 100% from the day your plan starts.
- Health Savings plans are available from Cigna with a comprehensive level of coverage and easy to use system of payment. Once you have met the deductible, Health Savings plans cover 100% of your in-network health care, including doctor’s office visits, inpatient hospital care, outpatient surgery, lab work and X-rays. By opening a health savings account, you can pay for cost sharing, deductibles and other medical services with the funds in your HSA. These plans offer preventive care at no cost with in-network providers as soon as your plan is active, and prescription drug benefits.
- Copay plans in Colorado are available in the following types: Enhanced Copay 80, Copay 80 and Copay 70. These plans cover a handful of services before you meet the deductible for a convenient and predictable rate. Deductible options are between $1,000 and $5,000 for Enhanced Copay 80 plans, $3,500 or $5,000 for Copay 80, and between $1,500 and $7,500 for Copay 70. Based on the plan you choose, the level of coverage will vary from either 70% or 80% after deductible. Each of these plans covers preventive care at 100% when using a network provider, and can be used immediately. Prescriptions are also covered at varying levels, with the most coverage and greatest discount available through the Enhanced Copay plan.
- Value 100% plans from HumanaOne come in deductible options of $5,000, %7,000 or $10,000 for individuals, and twice as much for those with dependents. From the start of your plan, preventive care is covered completely by your plan, including well child care, immunizations, office visits, lab work and screening for certain cancers. Once your deductible has been met, you can see an in-network provider for non-preventive office visits, specialist visits, inpatient hospital stays, emergency room visits, surgery, maternity care and more.
- HSA plans come in two types in Colorado: Enhanced HSA 100% and HSA 100%. Both options come with a wide range of deductibles, and the most benefits you can receive from any HumanaOne plan. These also have the capability of being used in conjunction with a health savings account (HSA), which gives you greater control over your medical spending. Once you have met the deductible, your HSA plan will cover 100% of all medical care, including visits to a primary care doctor or specialist, inpatient care, outpatient services, maternity care and emergency room services. Enhanced plans pay 100% after deductible on prescription drugs, while HSA 100 plans have a prescription discount card option.
- Deductible plans in Colorado are available in a range of deductibles, from $1,500 to $7,500 for individuals, all of which have 70% coverage after meeting the deductible. All Kaiser Permanente plans in Colorado are HMOs, which means you must choose a primary care doctor, get referrals for specialists, and there is no coverage for non-network providers. For deductibles between $1,500 and $4,000, there is an additional prescription benefit. All deductible plans come with the ability to use physician and prenatal services, and purchase prescriptions for a copay before meeting the deductible. As soon as your plan starts, you can receive preventive care from one of the HMO doctors in Colorado for no charge.
- HSA-Qualified Deductible HMO plans in Colorado have three deductible choices, $2,000, $2,500 and $3,000, and cover 80% of all medical services after deductible. prescription drugs are covered as well, with copays of $15 for generics and $30 for brand names after deductible. Preventive care services are no cost and can be used immediately when your plan starts, including immunizations, well child care, routine physicals and screenings. These plans cover maternity care, emergency room and urgent care visits, inpatient hospital care, surgery, diagnostic services and more. As suggested by the name, these plans can be used with health savings accounts for better use of medical spending, or saving for the future.
- Copay plans come in two types, including Copay Select and Copay Select Value. Both plans offer predictable copayments for doctor’s office visits, emergency care, and prescription drugs, but Copay Select offers a wider variety of options. Copay Select plans come with an unlimited number of doctor’s office visits and coverage on all tiers of prescription drugs, while the Value plan only covers the first four visits and generic drugs. After you meet your deductible, Value plans cover 70% of your major health care costs, and Copay Select plans cover either 70, 80 or 100% depending on the deductible. Preventive care is offered through both types of plans as soon as your plan begins for no cost in-network.
- High Deductible plans in Colorado are available in Plan 100, Saver 80 and Plan 80 options, with many deductibles to decide between. Varying with your choice of plan, you can receive medical care for 80 or 100% coverage after deductible. These plans offer a large array of benefits, including inpatient hospital care, outpatient surgery, lab work, emergency care and more. Before having met your deductible, you can receive preventive care from an in-network provider for no charge, including immunizations, well child care and routine physicals.
- Health Savings Account plans have a range of deductibles and coinsurance options of either 70/30 or 100% coverage after deductible. HSA plans cover everything from doctor’s office visits to prescription drugs, hospital care including emergency room visits, surgery, inpatient room and board, physical therapy and more after deductible. Without having to meet the deductible, you can see a doctor from the UnitedHealthOne network for preventive care at no cost. With funds from a health savings account, you have the opportunity to save for retirement or you can pay for cost sharing and other medical expenses.
Public Health Options
Colorado has certain programs funded by the state government to help residents with low income or medical needs receive health care. Some of these are provide ongoing health care coverage, such as Medicaid and Medicare, and others are assistance or prevention programs, giving access to prescription medications, immunizations, or designed for individuals with specific conditions. For a full list of the programs offered in Colorado, visit the Colorado Department of Health site. The following is a short collection of selected state-funded health programs in Colorado:
- Medicaid: health care coverage for families, children and certain individuals with low-income or have other health needs such as pregnant women, disabled persons, and women with breast or cervical cancer.
- CHP+: Child Health Plan Plus, an affordable health insurance programs for children and pregnant women who do not have insurance, but exceed the income limits for Medicaid in Colorado.
- Colorado Physical Activity & Nutrition (COPAN): a program to help prevent obesity and chronic illness, and to encourage wellness among Colorado residents.
- Women, Infants & Children (WIC): nutritional assistance for pregnant and breastfeeding women, and mothers with young children who have a low income.
- Women’s Wellness Connection: screenings for breast and cervical cancer available to women living in Colorado between ages 40 – 64 with limited or no health insurance.
Health Insurance Laws
In the state of Colorado, there are protective laws for both insurance companies and individuals who purchase insurance. As a result of health care reform, these laws are due to change in the near future, but for the time being they function in the following way. Insurance companies have the right to decide if an individual has a pre-existing condition based on the objective standard, which means the applicant has receive care in the past for a certain condition. While this is less lenient than other states’ definitions, insurers can still deny individuals for a plan, or accept them for a plan and increase their premiums.
Colorado insurance companies can also provide coverage to a person with a pre-existing condition but refuse to pay for the care of that condition for up to 12 months by adding an exclusion period to their plan. The use of elimination riders is also permitted, which state that the insurance company agrees to offer you coverage for everything except your pre-existing condition as long as you are insured by that company. These laws will soon change, as the Affordable Care Act prohibits the use of elimination riders and exclusion periods.
Under the ACA, all adults must be permitted to buy health insurance from any insurance company as of 2014. This will also include the state health exchanges created by the ACA. Due to this regulation, anyone with a pre-existing condition or who is considered high-risk can receive care for the same rate as someone in good health. Premiums will not be increased, and no limitations will be placed on the plan excluding a certain type of care. Children under the age of 19 already have this right, but adults have had to wait.
Until the law becomes effective, there is an alternative for Colorado residents with pre-existing conditions, called the Pre-Existing Condition Insurance Plan. These plans are run by the state of Colorado, and allocate funds for health insurance coverage for people who have been denied a policy, overcharged, or received unequal financial treatment due to their pre-existing condition. PCIPs work like a regular health insurance plan, with monthly premiums and basic services covered. They will expire at the end of 2013, and all who are on PCIPs will have to use a private insurer or state health exchange for medical coverage.
If you do have health insurance, there is a law that works in your favor. As long as you are paying your premiums and other necessary share of costs, and not violating your policy in any way, you are protected by HIPAA. One of the laws contained in HIPAA is guaranteed renewal, which states for one, that an individual who has insurance cannot have their benefits canceled as a result of illness acquired after enrollment in their plan. An additional piece of guaranteed renewability is that your insurance company is required to offer to renew your plan at the end of your term. This provision makes sure that once you have health insurance, you are entitled to continue using the coverage you purchased.