You’ve got your health insurance. Now what?
We understand that getting enrolled in your health insurance plan was the easy part. Now you are left with a daunting task…understanding your coverage, your benefits, and how to address any changes that might affect your coverage. Below are links and videos that we hope will help answer some of the most frequent questions that our Health Coverage Guides and Enrollment Navigators are asked every day. Some of these documents were created by our team and others were created by other health organizations such as Health & Human Services. Almost all of the following links will open a document or website that offers both English and Spanish translations.
As we identify community needs, this page will be updated so check back later for more information. It should also be noted that information that is supplied by other organizations often include their phone numbers. Please don’t hesitate to contact us, your local resource, if you have additional questions at 970.708.7096.
GENERAL QUESTIONS & HEALTH INSURANCE LITERACY
- What is “From Coverage to Care?”
This “roadmap” explains what health coverage is, and how to use it to get the primary care and preventive services to help you and your family get the most out of your coverage. Click here to download a copy of come by our office for a hard copy!
- Does Obamacare and the Affordable Care Act (ACA) work the same way?
A. Yes. The Affordable Care Act was signed into law by President Obama on March 23, 2010. It’s nickname is Obamacare.
- What is the purpose of Open Enrollment?
A. Open enrollment exists to incentivize individuals to keep an insurance plan, not risk being uninsured, and minimize switching between cheaper and expensive plans at the individual’s convenience. If everyone does not pay their fair share, premiums go up for everyone in order to cover a sick person’s medical expenses.
- What is a “Qualifying Life Change Event” or “Special Enrollment Period?”
A. A qualifying life change event opens up a special enrollment period so people, outside of open enrollment, can enroll in health insurance. These qualifying life change events include but are not limited to: loss of job, loss of health insurance, marriage, adding a child to the household, etc. When a life change event occurs, you should contact your local Health Coverage Guide, 970-708-7096, or Connect for Health Colorado Customer Service at 1-855-PLANS-4-YOU (1-855-752-6749) to report the event and make any necessary changes to your policy. You must report this change within 60 days of the qualifying event. To read more about qualifying life change events, click here. To view a short video by TCHNetwork on life change events, click here .
- ¿Qué es un “Evento de Cambio de Vida Calificado” o un “Período de Inscripción Especial?”
R. Un evento de cambio de vida calificado abre un período de inscripción especial para que las personas se puedan inscribir en un seguro de salud fuera del Período de Inscripción Abierta. Estos eventos de cambio de vida calificados incluyen, pero no están limitados a: pérdida de trabajo, pérdida de seguro de salud, matrimonio, añadir un hijo al hogar, etc. Cuando un evento de cambio de vida ocurre, usted debe contactar a su Guía de Cobertura de Salud local al 970-708-7096, o a Servicio del Cliente de Connect for Health Colorado al 1-855-PLANS-4-YOU (1-855-752-6749) para reportar el evento y hacer cualquier cambio necesario a su política. Usted debe reportar este cambio dentro de 60 días del evento calificado. Para ver un video corto de TCHNetwork acerca de eventos de cambio de vida, haga clic aquí.
- What are “Essential Health Benefits?”
A.A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services. Plans must offer dental coverage for children. Dental benefits for adults are optional. Specific services may vary based on your state’s requirements. You’ll see exactly what each plan offers when you compare plans.
- What are “Preventive Benefits?”
A. Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems. Most health plans must cover a set of preventive services — like certain shots and screening tests — at no out-of-pocket cost to you. This includes plans available through a Health Insurance Marketplace and is true even if you haven’t met your yearly deductible. Note: to receive these services at no additional cost, make sure to get them from a doctor or other provider in your plan’s network. For a comprehensive live of adult preventive benefits, click here. For children, click here.
- What is Federal Poverty Level (FPL)?
A. FPF is a measure of income issued every year by the Department of Health and Human Services (HHS). FPLs are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHP+ coverage. The 2017 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHP+). To learn more, click here.
- Can you help me understand insurance terms like premium and co-pay?
A. If you are baffled by premiums, deductibles and out-of-pocket maximums, understanding basic insurance terms will take you a long way in understanding how your health insurance works. This short video by TCHNetwork will help you better understand these basic terms. If you still have questions, call us — we’re here to help! Click here for our short video.
- ¿Me puede ayudar a entender términos de seguro, como cuota y copago?
R. Poder entender los términos básicos de seguros te ayudará a entender cómo funciona tu seguro de salud. Este video presentado por TCHNetwork te ayudará a entender estos términos básicos. Si es que todavía tienes preguntas, llámanos – ¡estamos aquí para ayudarte! Haz clic aquí para nuestro corto video.
- Who is in my plan’s Network? Why is this important?
A. Your insurance company contracts with medical providers, facilities and suppliers. Generally you will pay less if you use providers, facilities or suppliers in your plan’s network. Networks can change during the life of your plan. Check your Summary of Benefits or call your insurance company if you have more questions. Click here for a short video.
- How does my health insurance cover prescription drugs?
A. The amount you pay for your prescriptions will depend on the health insurance plan you select. Before selecting a plan, make sure you understand how your prescription is listed. Click here for a short video about prescription drug coverage.
- What is a Health Savings Account (HSA)?
A. Health Savings Accounts, along with a Qualified Health Plan, can be a good option for some people. It is important to understand how they work. Check with your insurance broker and/or tax adviser to see if HSAs, along with a high-deductible qualified health plan are a good fit for you. Click here for a short video that will teach you more about HSAs.
- What is my PEAK account and how does it work?
A. Whether you are a Colorado Medicaid recipient or you’ve purchased health insurance through Connect for Health Colorado, understanding how to navigate your Colorado PEAK account is essential. From this website you can make changes to your contact information, mailing address, and income. This is also where you can track all correspondences including your eligibility determination and necessary tax documents. Click here for a TCHNetwork short video.
- ¿Qué es mi cuenta de PEAK y cómo funciona?
R. Si usted es recipiente de Medicaid de Colorado o si usted ha comprado seguro de salud por medio de Connect for Health Colorado, es esencial que usted entienda cómo navegar su cuenta de Colorado PEAK. Desde este sitio web, usted puede hacer cambios a su información de contacto, dirección de envío e ingresos. Aquí es dónde usted también puede seguir todas sus correspondencias, incluyendo su determinación de elegibilidad y documentos necesarios de impuestos. Haga clic aquí para un video corto de TCHNetwork.
- I will be turning 65 in October. Do I keep my insurance plan until the end of the year? What do I need to do to sign up for Medicare?
A. No. You will need to sign up for your Medicare with the social security administration and decide if you would like a supplemental plan through a company of your choice. A good local resource is Region 10 at 888-696-7213. They have information on all the Medicare plans and a list of company’s available. You have 3 months before and 3 months after you turn 65 to sign up for medicare.
- What is Tricare?
A. Tricare is the military’s health insurance program, and it comes in four varieties: Tricare Prime, Tricare Extra, Tricare Standard, and Tricare for Life. Tricare covers everyone — active-duty members, retirees, and their families. However, retirees and their dependents have to chip in for the cost of coverage.
COLORADO’S INSURANCE MARKETPLACE – Connect for Health Colorado
- Is there a way to calculate my potential savings and narrow down my preferences for choices of coverage?
A. Yes. You can check if you’re eligible for financial assistance to help lower your monthly costs (including Medicaid and CHP+) and view plans that include your preferred doctors, hospitals/facilities and medications. To get an estimate of what you might qualify for including Medicaid and CHP+ , click here.
- Why is it important to report a change in my income?
A. Your eligibility for certain programs may change based on your income. You might fall in or out of Medicaid eligibility or your tax credits might be increased or reduced. Your tax liability at the end of the year could be in jeopardy based on whether or not you accurately report your income. Click here to view a short TCHNetwork video about how and when to report an change in your income.
- I have not received a bill from my insurance carrier. How do I pay my premium?
A. 1) Contact Connect for Health Colorado to determine that your enrollment information was sent to your carrier. 2) If not, ask them to guarantee the “start date” of your plan – ask for an incident / tracking number to document this phone call. 3) If they determine that your information was correctly sent to your insurance carrier ask for an incident / tracking number to document this phone call. 4) Contact your insurance carrier and let them know that you have not received an invoice and that you need to pay your first bill. It is very important that you do this before the 1st of the month that your insurance begins coverage. Without this payment your insurance carrier can cancel your insurance coverage. Ask them for a tracking number to document this phone call. 5) Ensure that your insurance carrier has the correct mailing address for future correspondences.
- What are Advanced Premium Tax Credits and Cost Share Reductions?
A. APTC stands for Advanced Premium Tax Credits. These are granted to people based on their family size, household income, and the average plan prices in their area. Based on this criteria, APTC’s lower a plan’s monthly premium. CSR stands for Cost Sharing Reduction using the same criteria, CSR’s can lower a plan’s deductible, co-payment and out-of-pocket maximum.
- I’m turning 26 this year and am losing coverage through my parents. What should I do?
A. If you have health insurance under your parent’s plan and are turning 26 this year, you have options for coverage. Your options will depend on whether your parent’s plan is through their job or the Colorado’s health insurance marketplace, Connect for Health Colorado. Click here to view a video by TCHNetwork explaining what steps you need to take to get enrolled if you’re turning 26.
- Cumplo 26 este año y pierdo cobertura bajo mis padres. ¿Qué debo hacer?
R. Si tienes seguro de salud bajo el plan de tus padres y cumples 26 este año, tienes opciones para cobertura. Tus opciones dependerán de si el plan de tus padres es por medio de su trabajo o el mercado de seguros de salud de Colorado, Connect for Health Colorado. Haz clic aquí para ver un video de TCHNetwork explicando qué pasos debes tomar para inscribirte en un seguro de salud si vas a cumplir 26.
- My child is turning 19 this year and losing CHP+ coverage. What should I do?
A. You need to contact your local health coverage guide (970.708.7096) or Connect for Health Colorado at 1-855-752-6749 before the 15th of the month that your child turns 19. This will ensure an effective date of the 1st of the following month, thereby avoiding a lapse in coverage for your child.
- I just lost my employer sponsored health insurance coverage. Can I enroll into the marketplace?
A. Yes. You have 45 days to enroll because you must enroll by the 15th of the month to ensure a 1st of the following month start date. You are allowed 2 months out of 12 to be uninsured without a penalty. To avoid a lapse in your coverage, enroll prior to the 15th of the month you are losing your employer sponsored coverage.
- I am insured through the marketplace but recently qualified for Medicaid. Do I need to cancel my marketplace plan?
A. Yes. Contact your local health coverage guide or Connect for Health Colorado and cancel your health insurance immediately – ask for an incident number to track this request. You will be given an end-of-month termination date. If you already paid for your current month of coverage continue to use your coverage until the end of the month; then begin to use your Medicaid the following month.
- Since my health insurance was not cancelled until the end of the month but I qualified for Medicaid at the beginning of the month, will I have to pay back my tax credits?
A. No. The Internal Revenue Service (IRS) rules for premium tax credits say that people receiving advance payments who are determined to be eligible for Medicaid on a retroactive basis are treated as being eligible for minimum essential coverage no earlier than the first day of the first calendar month after approval of the Medicaid application. The IRS rules have a helpful example to illustrate this. In the example: “F” is receiving advance payments when she loses her part-time job. She applies for Medicaid on April 10, 2017. Her application is approved retroactive to April 1. Based on this, F is not considered to have minimum essential coverage until May 1, 2015, the first day of the calendar month after approval of her Medicaid application.
- I turn 65 in September. When do I cancel my marketplace plan?
A. It is best to cancel your marketplace plan at least one month before you turn 65. For example: if you turn 65 September 22, then your Medicare will start September 1st. You will need to cancel your marketplace plan by the 1st of August or at least before the 15th of August to have it end by the 31st of August.
COLORADO MEDICAID (HEALTH FIRST COLORADO)
- What are my Medicaid benefits and services?
A. Click here to learn about your Medicaid benefits. This is straightforward list that lays out your benefits, co-payments, dental benefits and more.
- How do I print my Medicaid card?
A. Your Medicaid card should arrive in 7-10 days and will be sent to the address on your application. You do not need a copy of your Medicaid card to get medical services, you only need your State ID Number. You can also print your Medicaid card through PEAK. Click here to watch our short video on navigating your PEAK account.
- Does Medicaid cover physical therapy?
A. Although it is stated in the benefits overview that Medicaid recipients can see a PT 60 times per acute injury, what it should say is that Medicaid recipients have 60 billing codes per acute injury. Meaning: for one injury a physical therapist can bill 5-8 codes. With this understanding, to be safe Medicaid recipients can expect to see a physical therapist for about 8 visits. Consult your physical therapist regarding how many visits you might be able to receive.
- What is the Accountable Care Collaborative versus ACC Rocky Mountain Health Plans (RMHP) Prime?
A. If you live in Ouray or San Miguel Counties you are a member of the Accountable Care Collaborative (ACC). The ACC is Colorado Medicaid’s primary health care program. Click here to watch a short video and learn more about the ACC. If you live in Montrose County you are a member of the ACC Rocky Mountain Health Plan (RMHP) PRIME. Click here to learn more about ACC RMHP Prime.
- Where can I get a Medicaid Member Handbook?
If you haven’t received your Member Handbook in the mail, choose one of the these links to download a copy of your Medicaid Member Handbook: English or Spanish.
- Does Medicaid include adult dental benefits?
A. Yes! You read this right! If you are an adult and you qualify for Medicaid, you will receive dental benefits. To understand the full list of benefits, click here. Your $1,000.00 dental benefit run from July 1st through June 30th. Any unused money from the current year will not roll over to the next year; but you will receive a brand new $1,000 benefit on July 1st of every year. You must see a dental care provider that accepts your county’s Medicaid.
- What is Medicaid’s child dental benefit?
A. Children on Health First Colorado are entitled to preventive services including exams, cleanings, x-rays, sealants, space maintainers, fluoride treatments and more. Like adults, they receive a $1,000.00 dental benefit per year, beginning July 1st through June 30th. Like adults, any unused portion of this benefit does not roll-over into the next year, but does renew at $1,000.00. Click here to learn about your child’s benefits!
- I just lost my Medicaid. Can I enroll into the state marketplace?
A. Yes. To avoid a gap in coverage contact a health coverage guide (970.708.7096) or Connect for Health Colorado during the month that you lose your coverage. You must have insurance for 10 of 12 months to avoid a penalty for being uninsured.
- I qualified for Medicaid but I have already paid for this month’s coverage through Connect for Health Colorado. Which insurance do I use?
A. First contact Connect for Health Colordo and cancel your health insurance plan – ask for an incident number to track this request – you will receive an end-of-the-month termination date. Second, continue to use your current coverage until the end of the month. Begin using your Medicaid the following month.
- When I sign up for Medicare will my Medicaid be automatically cancelled?
A. No. You must report your change through your PEAK account or your local Health and Human Services Office. You can also contact your local health coverage guide.
- I have Tricare. Is it possible to enroll into Medicaid as a supplemental plan?
A. Yes. Your Medicaid eligibility will depend on the number of people in your tax household as well as your income.
- Does open enrollment apply to Medicaid?
A. No. You can enroll into Medicaid at any point in the year, if you meet Medicaid eligibility requirements.
CHILD HEALTH PLANS PLUS (CHP+ or CHIP)
- What is Child Health Plans Plus (CHP+ or CHIP)?
A. Child Health Plan Plus (CHP+) is public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Medicaid, but not enough to pay for private health insurance. CHP+ costs vary depending on your household size and income. CHP+ members may have to pay an annual enrollment fee. This fee is due within 30 days of your CHP+ approval. To learn more about the benefits of CHP+, click here.
Click here to learn more about your CHP+ service area, specialty care and specialty services.
- How is CHP+ different from Medicaid?
A. Medicaid is for low income Coloradans who make less than about $1,300 a month for an individual. CHP+ is for low income children and pregnant women who make too much to qualify for Medicaid. The benefits are similar and both include dental.
- What is the Annual Enrollment Fee for CHP+?
The standard fees are: – $0 for an adult pregnant woman in the CHP+ Prenatal Care – $25 to enroll one child – $35 to enroll two+ kids – American Indians and Alaskan Natives do not have to pay a fee – Families earning more than 214% of the Federal Poverty Level will pay higher fees: $75 to enroll 1 child; 105 to enroll 2+
- Do I receive dental benefits with CHP+?
A. Delta Dental of Colorado provides dental benefits to all eligible and enrolled CHP+ child members. These benefits include preventive and diagnostic services, restorative services, endodontic, periodontic, prosthodontic, oral surgery, and limited orthodontic services. There will be a maximum allowable of $1000.00 per child per calendar year (January 1 – December 31). As with all CHP+ benefits, higher income families may be required to pay a small fee when they receive services. However, dental benefits do not become active until 60 days after your CHP+ start date. For example: You become eligible for CHP+ beginning October 1st; your dental benefits begin December 1st. Delta Dental has an interactive website that can give you more information, just click here
- Are there co-payments (co-pays) with CHP+?
A. Based on Federal Poverty Level: You may have to pay small co-payments. There are no co-payments for preventative care. Other services may require co-payments that vary based on your income. Native Americans and Alaskan Natives do not have to pay co-payments.
- How do I find a doctor, specialist or dentist that takes Medicaid?
A. The Colorado Medicaid website (Colorado Department of Health Care Policy & Financing) can help you locate all types of doctors, specialists and dentists that accept Medicaid. The website tool is user friendly and can be found if you click here.
- I am a US citizen and newly married to an immigrant who does not live in the US. He does not send me any money. I am pregnant. To qualify for CHP+ am I a family of 2 or 3?
A. You are a family of 2.
CITIZENSHIP & HEALTH INSURANCE
- If I apply for health insurance, how is my information used?
A. Information about immigration status will be used only to determine eligibility for coverage and not for immigration enforcement.
- Si solicito seguro de salud, ¿Cómo será usada mi información?
R. La información sobre el estatus migratorio será usada sólo para determinar su elegibilidad para cobertura médica y no por la ley de inmigración.
- What citizenship statuses qualify for insurance?
A. Immigrants with the following statuses qualify to use the Marketplace: 1) Lawful Permanent Resident (LPR/Green Card holder) 2) Asylee 3) Refugee 4) Cuban/Haitian Entrant 5) Paroled into the U.S. 6) Conditional Entrant Granted before 1980 7) Battered Spouse, Child and Parent 8) Victim of Trafficking and his/her Spouse, Child, Sibling or Parent 9) Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention against Torture (CAT) 10) Individual with Non-immigrant Status, includes worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau 11) Temporary Protected Status (TPS) 12) Deferred Enforced Departure (DED) 13) Deferred Action Status (Exception: Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying for health insurance) 14) Lawful Temporary Resident 15) Administrative order staying removal issued by the Department of Homeland Security 16) Member of a federally-recognized Indian tribe or American Indian Born in Canada 17) Resident of American Samoa
- ¿Qué estatus de ciudadanía califican para un seguro de salud?
R. Los inmigrantes con los siguientes estatus califican para usar el Mercado de Seguros: 1) Residente permanente legal (LPR/Portador de una tarjeta de residente permanente) 2) Asilado 3) Refugiado 4) Participante Cubano-Haitian 5) Bajo entrada condicional en los EE.UU. 6) Persona presente bajo entrada condicional concedida antes de 1980 7) Cónyuge, o hijo y pariente maltratado 8) Víctima del tráfico de personas, y su cónyuge, hijo, hermano o pariente 9) Suspensión de deportación o remoción otorgada, bajo las leyes de inmigración o bajo el Convenio contra la tortura (CAT, por su sigla en inglés) 10) Individuo con estatus de no-inmigrante, incluye visas de trabajo (tal como H1, H2A, H-2B), visas de estudiante, U-visa, T-visa y ciudadanos de Micronesia, las Islas Marshall, y Palau 11) Estatus de protección temporal (TPS, por su sigla en inglés) 12) Partida forzada diferida (DED, por su sigla en inglés) 13) El Estatus de acción diferida (Excepción: la Acción Diferida para los llegados a EE.UU. en la infancia. (DACA, por su sigla en inglés) no es un estatus de inmigración elegible para solicitar seguro médico) 14) Residente temporal legal 15) Orden administrativa aplazando una remoción, emitida por el Departamento de seguridad nacional 16) Miembro de una tribu nativa estadounidense reconocida federalmente, o indígena estadounidense nacido en Canadá 17) Residente de Samoa Americana
- I am a legally present immigrant. I have a green card. Can I get health insurance?
A. An immigrant that is legally present (has a green card) for less than 5 years and does not qualify for Medicaid or CHP+ might qualify for lower cost health insurance through the Colorado’s insurance marketplace. As an immigrant, navigating health insurance in the United States can be difficult, but Tri-County Health Network will help you understand the health insurance options available to you and your loved ones. To see our informational video about your options, click here. If you have any questions or need help applying for health insurance, call us! We offer bilingual help to anyone that needs it.
- Soy un inmigrante con residencia legal. Tengo una tarjeta verde. ¿Puedo obtener seguro de salud?
R. Como inmigrante, puede ser difícil navegar los seguros de salud en los Estados Unidos, pero Tri-County Health Network te ayudará a entender las opciones disponibles para ti y tus seres queridos con respecto a la cobertura médica. Para ver nuestro video con información acerca de tus opciones, haz clic aquí. Si es que tienes alguna duda o necesitas ayuda para inscribirte en un seguro de salud, ¡llámanos! Ofrecemos ayuda bilingüe para quienes lo necesiten.
- I am not a legal permanent resident and I do not meet the citizenship status criteria. Do I have any options for insurance coverage?
A. You can purchase health insurance through Connect for Health Colorado or a licensed insurance broker but you cannot qualify for subsidized coverage through the Affordable Care Act, through Medicaid or CHP+.
- No soy un residente legal permanente y no cumplo con los criterios de estatus de ciudadanía. ¿Tengo algunas opciones para cobertura médica?
R. Puedes comprar cobertura médica en Connect for Health Colorado o por medio de un corredor de seguros calificado, pero no puedes calificar para cobertura subsidiada mediante la Ley de Cuidado de Salud Asequible.
- What is a Qualified Non-Citizen?
A. The term “qualified non-citizen” includes: 1) Lawful Permanent Residents (LPR/Green Card Holder) 2) Asylees 3) Refugees 4) Cuban/Haitian entrants 5) Paroled into the U.S. for at least one year 6) Conditional entrant granted before 1980 7) Battered non-citizens, spouses, children, or parents 8) Victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa 9) Granted withholding of deportation 10) Member of a federally recognized Indian tribe or American Indian born in Canada
- ¿Qué es un No Ciudadano Calificado?
R. El término “no ciudadano calificado” incluye a: 1) Los residentes permanentes legales (LPR/con la tarjeta verde) 2) Asilados 3) Refugiados 4) Inmigrantes Cubanos/Haitianos 5) Permiso condicional para estar en los EE.UU. al menos por un año 6) Ingreso condicional otorgado antes de 1980 7) Cónyuges, hijos y padres abusados que no son ciudadanos 8) Víctimas del tráfico humano/de personas y sus cónyuges, hijos, hermanos o padres, o individuos con una solicitud pendiente para una visa de víctima de tráfico humano 9) Personas a las que les han interrumpido la deportación 10) Miembro de una tribu indígena reconocida federalmente o Indio-americano nacido en Canadá.
- I am a Qualified Non-Citizen. Do I qualify for health insurance programs?
A. Yes. You are subject to Medicaid/CHP+ and Marketplace income guidelines that will determine your eligiblity for a specific program. You must have the appropriate documentation to be able to complete an enrollment.
- Soy un No Ciudadano Calificado. ¿Califico para programas de seguro de salud?
R. Sí. Usted es sujeto a las pautas de ingresos de Medicaid/CHP+, que determinan su elegibilidad para un programa específico. Usted debe tener la documentación apropiada para poder completar una inscripción.
- I have DACA. Am I eligible for health insurance assistance programs?
A. You may qualify for emergency Medicaid or buy private health insurance but you do not qualify for cost assistance.
- Tengo DACA. ¿Soy elegible para programas de asistencia para seguros de salud?
R. Usted puede calificar para Medicaid para Emergencias o comprar un seguro de salud privado, pero no califica para asistencia con costos.
- I have Employment Authorization. Do I qualify for health insurance programs?
A. People with the following statuses and who have employment authorization qualify for the Marketplace: 1) Registry Applicants 2) Order of Supervision 3) Applicant for Cancellation of Removal or Suspension of Deportation 4) Applicant for Legalization under Immigration Reform and Control Act (IRCA) 5) Legalization under the LIFE Act
- Tengo Autorización de Empleo. ¿Califico para programas de seguro de salud?
R. Las personas con los siguientes estatus y que tienen autorización de empleo califican en el Mercado: 1) Solicitantes a través de registro 2) Orden de supervisión 3) Solicitante para cancelación de remoción o suspensión de deportación 4) Solicitante para legalización bajo IRCA (Immigration Reform and Control Act) 5) Legalización bajo la Ley LIFE
- What is Emergency Medicaid?
A. Emergency Medicaid is short term coverage for immigrants without legal permanent residency or Naturalization status. Emergency Medicaid only covers life and limb threatening situations, and does not cover doctor appointments or routine care. To apply you must visit your local Health & Human Services Office. Click here to find your local office. For more information contact one of Tri-County Health Network’s bilingual enrollment navigators: Kody Gerkin at 970.708.0938 or Claudia Gamez at 970.708.4456.
- ¿Qué es Medicaid para Emergencias?
R. Medicaid para Emergencias es cobertura de corto plazo para inmigrantes sin residencia legal permanente o estatus de naturalización. Medicaid para Emergencias sólo cubre situaciones con peligro de vida o pérdida de extremidades, y no cubre citas al doctor o cuidado de rutina. Para solicitarlo, usted debe visitar su oficina local de Salud y Servicios Humanos. Haga clic aquí para encontrar su oficina local. Para más información contacte a uno de los navegadores de inscripción bilingües de Tri-County Health Network: Kody Gerkin al 970.708.7096 o Claudia Gamez al 970.708.4456.
CHOOSING TO REMAIN UNINSURED
- What is the penalty for remaining uninsured?
A. If you can afford health insurance but choose not to buy it, you must pay a fee called the individual shared responsibility payment. This fee is sometimes called the “penalty,” “fine,” or “individual mandate.” The penalty for not having health insurance in 2017 is $695 per uninsured person or 2.5% of your household income, whichever is greater. Before you decide to remain uninsured, use the Penalty Calculator to estimate the cost of this choice.
- Is there any way to be exempt from purchasing health insurance? What about exemption from the penalty?
A. Yes. Health coverage exemptions are available for a variety of reasons: certain life events, health coverage or financial status, group membership, and more. In some cases, you may be able to get an exemption from the penalty for remaining uninsured, which means you wouldn’t have to pay the penalty. To learn more about the exemption from penalty, click here. Wondering if you qualify for an exemption? Healthcare.gov offers a useful tool: Click here to learn more.
NECESSARY DOCUMENTS FOR FILING YOUR INCOME TAXES
Employees of Tri-County Health Network are not tax accountants. We can, however, offer you the following information regarding the documents you will need when reconciling your taxes:
- 1095A – This document is necessary to reconcile your taxes if you received a Marketplace tax credit. You will find it in the MY DOCUMENTS folder of your connectforhealthco.com account. If this form is not found in MY DOCUMENTS, contact Connect for Health Colorado at 1.855.752.6749.
- 1095B – This document proves that you were enrolled into a qualified health plan for the tax year. You will receive this document from Medicaid/CHP+ or your health insurance carrier. If you do not receive this document, contact your local Health and Human Services office.
- 1095C – This document is necessary if you receive employer sponsored health coverage. Your employer will supply this document.
CONTACT INFORMATION FOR ASSISTANCE
Tri-County Health Network (TCHNetwork) provides insurance enrollment and education assistance for Colorado’s marketplace (Connect for Health Colorado), Health First Colorado (Medicaid), and Child Health Plans Plus (CHP+ or CHIP). Below, find contact information for assistance by organization:
- TCHNetwork Health Coverage Guide, click here. You can also contact TCHNetwork directly at 1.970.708.7096.
- Connect for Health Colorado: 1.855.752.6749 or click here.
- Health First Colorado (Medicaid): 1.800.221.3943 or click here.
- San Miguel County Health and Human Services: 1.970.728.4411
- Ouray County Health and Human Services: 1.970.626.2299
- Anthem BlueCross BlueShield of Colorado: 1.855.453.7031 or click here.
- Child Health Plans Plus of Colorado: 1.800.359.1991, the mailing address is Department of Health Care Policy & Financing, P.O. Box 17548, Denver CO 80217