How Am I Protected?

We regret that, because of a loss of financial support, this website no longer provides current information. As a result, the Georgetown University Health Policy Institute cannot warrant the accuracy or adequacy of the information or materials on this site. If you are interested in supporting the work of the Georgetown University Health Policy Institute, please contact us at (202) 687-0880. Thank you.

In Colorado, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, however the laws protect you in the following ways.

· Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination. (see Group Health Plans)

· All group health plans in Colorado must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage. (see Group Health Plans)

· Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable. (see Individual Health Plans for Individual Coverage, and Small Employer or Self-Insured Person for Small Group Coverage)

· If your son or daughter is in college and covered as a dependent under your group, but cannot maintain student status due to illness, he or she may still be able to remain covered as your dependent for up to one year. (see Group Health Plans)

· If you leave your job, you may be able to remain in your old group health plan for a certain length of time. This is called COBRA or state continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage. (see Group Health Plans)

· If you lost your group health plan because of involuntary termination of employment that occurred between September 1, 2008 and December 31, 2009, you may be eligible for a federal tax credit that can help you pay for your COBRA or state continuation coverage premiums for up to nine months. (see Individual Health Plans)

· If you lose your group health plan and meet other qualifications, you will be HIPAA eligible. If so, you can buy an individual health insurance policy from the state high-risk pool, CoverColorado. You will not face a new pre-existing condition exclusion period. There are limits on what you can be charged for a CoverColorado policy. (see Group Health Plans)

· If you have had difficulty obtaining affordable individual health insurance because of your health condition, you may also be able to buy insurance from CoverColorado. In this case you may face a new pre-existing condition exclusion period. There are limits on what you can be charged for a CoverColorado policy. (see Group Health Plans)

· If you lose your fully insured group health plan and meet other qualifications, you may be eligible to buy a conversion policy. You will not face a new pre-existing condition exclusion period. (see Group Health Plans)

· When you apply for an individual health insurance policy, insurance companies may not turn you down, charge you more or impose a pre-existing condition exclusion period because of your genetic information. In addition, insurance companies are not allowed to even ask about your genetic tests or family history when you apply for coverage. (see Group Health Plans)

· If you are a small employer buying a group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. All fully insured health plans for small employers must be sold on a guaranteed issue basis. (see Small Employer or Self-Insured Person)

· If you are a small employer buying a small group plan, you cannot be charged higher premiums based on the health status and claims history of those in your group. However, premiums will vary based the age, geographic area, industry of your group and other factors. This is called modified community rating. (see Small Employer or Self-Insured Person)

· As a small employer, you cannot be turned down or charged more because of the genetic information of a member of your group. In addition, insurance companies are not allowed to even ask about genetic tests or family history of people in your group when you apply for coverage. (see Small Employer or Self-Insured Person)

· If you are self-employed or an employer with a sole employee, you may qualify to buy a small group health plan policy as a business group of one. (see Small Employer or Self-Insured Person)

· If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Colorado Medicaid program offers free health coverage and other assistance for qualifying families, children, pregnant women, elderly and disabled individuals. (see Financial Assistance)

· If your child is 18 years old or younger, does not have health insurance and meets other qualifications, you may be able to enroll them in the Child Health Plan Plus (CHP+) program. CHP+ offers free or reduced price health coverage for children who do not qualify for Medicaid. (see Financial Assistance)

· If you believe that you may be at risk for cancer, you may be eligible for free screening and treatment. The Women’s Wellness Connection (WWC) provides qualified women with free breast and cervical cancer screening. In addition, women diagnosed with cancer through this program may be eligible for medical care through the Colorado Medicaid program. (see Financial Assistance)

· If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program, you may be eligible for a federal income tax credit to help you pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and is equal to 80% of the cost of qualified coverage, including COBRA, state continuation coverage, and CoverColorado. (see Financial Assistance)

· If you are a retiree aged 55-65 and receiving benefits from Pension Benefit Guarantee Corporation (PBGC), then you may be eligible for the HCTC. (see Financial Assistance)


AddThis Social Bookmark Button