Child Health Plan Plus (CHP+)

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Federal funding for the Children’s Health Insurance Program (CHIP), known as Child Health Plan Plus (CHP+) in Colorado, ended on September 30, 2017. The Department of Health Care Policy and Financing, the agency administering CHP+, estimates the state’s reserved funding for CHP+ in Colorado will last through January 31, 2018.

Unless Congress acts to reauthorize funding for CHP+, individuals enrolled in CHP+ will only have coverage through January 31, 2018. There are no changes to CHP+ through January 31, 2018, and current CHP+ enrollees should continue to access care like normal until that time. You can track the latest developments that impact the CHP+ program here.

If you receive a letter letting you know that your CHP+ coverage is ending, you may want to consider enrolling through Connect for Health Colorado, the only place where you can access financial help to lower the cost of your coverage. In many cases, this financial help makes health coverage very affordable. There are two types of financial help available:

  1. Premium Tax Credits help pay your monthly health insurance premium.
  2. Cost-Sharing Reductions lower the amount you pay when you receive care.

Who can qualify for Premium Tax Credits?

If the funding for CHP+ is not reauthorized, many individuals currently receiving CHP+ may qualify for Premium Tax Credits. Premium Tax Credits can be used to lower the monthly premium of a Qualified Health Plan purchased through Connect for Health Colorado. If your household’s income falls in the ranges below, you may qualify for Premium Tax Credits.

 

Who can qualify for Cost-Sharing Reductions?

If your household qualifies for Cost-Sharing Reductions and you enroll in a Silver level plan, your health insurance company will reduce the amount of out-of-pocket expenses your household is responsible for. This includes how much you would have to pay for co-pays, deductibles and coinsurance for covered healthcare services your household receives. Depending on your income there are three levels of savings:

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The typical Silver level plan will cover about 70% of a person’s medical costs. With Cost-Sharing Reductions, that percentage increases depending on the size of your household and your annual income. Despite what you may have heard in the media, this financial help, in addition to Premium Tax Credits, is still available to customers who qualify and purchase health insurance plans in 2018. Learn more about the financial help available through Connect for Health Colorado.

 

How much could you save?

The amount of Premium Tax Credit you may qualify for is based on your age, income, and where you live. Here’s how much you could save, depending on the number of people in your household, if Congress does not act to reauthorize funding for the CHP+ program. Keep in mind, this chart is intended to provide you with a general sense of the amount of financial assistance someone may be eligible to receive. If you are older or younger than the individuals listed in the example above each table, your Premium Tax Credit amount may be different.

Here is an example for a household of 4:

The Smith household, father (age 40), mother (age 35), and two children (age 7 and 5), have an annual income of $49,200. If they live in Boulder (zip code 80301), they would qualify for $1,050 Premium Tax Credit and Cost-Sharing Reduction of 87%, which means the health insurance company they select would be responsible for 87% of their medical costs. Note: These figures are estimates.

 

Premium Tax Credit Estimates for a Household of 4

Cost-Sharing Reductions 94% 87% 73% Not Eligible
Annual Income Up to $36,900 $36,901 – $49,200 $49,201 – $61,500 $61,501 – $98,399
Boulder Up to $1,190 $1,050 – $1,190 $900 – $1,050 $535 – $900
Colorado Springs Up to $1,160 $1,020 – $1,160 $860 – $1,020 $500 – $860
Cortez Up to $2,050 $1,920 – $2,050 $1,760 – $1,920 $1,390 – $1,760
Craig Up to $2,090 $1,960 – $2,090 $1,800 – $1,960 $1,430 – $1,800
Denver Up to $1,170 $1,040 – $1,170 $880 – $1,040 $510 – $880
Fort Collins Up to $1,320 $1,190 – $1,320 $1,030 – $1,190 $660 – $1,030
Grand Junction Up to $1,710 $1,580 – $1,710 $1,420 – $1,580 $1,050 – $1,420
Greeley Up to $1,320 $1,190 – $1,320 $1,030 – $1,190 $660 – $1,030
Pueblo Up to $1,300 $1,160 – $1,300 $1,000 – $1,160 $640 – $1,00
Springfield Up to $1,590 $1,450 – $1,590 $1,300 – $1,450 $930 – $1,303
Sterling Up to $1,620 $1,480 – $1,620 $1,330 – $1,480 $960 – $1,330


Here is an example for a household of 3:

The Martinez household, father (age 42), mother (age 47) and their son (age 12) are seeking health insurance coverage. Their expected annual income for 2018 is $51,050. If they live in Grand Junction (zip code 81501), they would qualify for $1,320 Premium Tax Credit and Cost-Sharing Reduction of 73%, which means the health insurance company they select would be responsible for 73% of their medical costs. Note: These figures are estimates.

 

Premium Tax Credit Estimates for a Household of 3

Cost-Sharing Reductions 94% 87% 73% Not Eligible
Annual Income Up to $30,630 $30,631- $40,840 $40,841 – $51,050 $51,051- $81,679
Boulder Up to $1,090 $980 – $1,090 $850 – $980 $540 – $850
Colorado Springs Up to $1,060 $940 – $1,060 $820 – $940 $510 – $820
Cortez Up to $1,870 $1,760 – $1,870 $1,630 – $1,760 $1,320 – $1,630
Craig Up to $1,910 $1,790 – $1,910 $1,660 – $1,790 $1,360 – $1,660
Denver Up to $1,070 $960 – $1,070 $830 – $960 $530 – $830
Fort Collins Up to $1,210 $1,100 – $1,210 $970 – $1,100 $660 – $970
Grand Junction Up to $1,670 $1,450 – $1,560 $1,320 – $1,450 $1,010 – $1,320
Greeley Up to $1,210 $1,100 – $1,210 $970 – $1,100 $660 – $970
Pueblo Up to $1,180 $1,070 – $1,180 $940 – $1,070 $640 – $940
Springfield Up to $1,450 $1,340 – $1,450 $1,210 – $1,340 $900 – $1,210
Sterling Up to $1,480 $1,370 – $1,480 $1,240 – $1,370 $930 – $1,240


Here is an example for a household of 2:

Eric (age 50) and his daughter (age 13) are applying for health insurance. Eric’s expected annual income for 2018 is $24,360. If they live in Colorado Springs (zip code 80917), they would qualify for $730 Premium Tax Credit and Cost-Sharing Reduction of 94%, which means the health insurance company they select would be responsible for 94% of their medical costs. Note: These figures are estimates.

 

Premium Tax Credit Estimates for a Household of 2

Cost-Sharing Reductions 94% 87% 73% Not Eligible
Annual Income Up to $24,360 $24,361 – $32,480 $32,481 – $40,600 $40,601 – $64,959
Boulder Up to $750 $660 – $750 $560 – $660 $310 – $560
Colorado Springs Up to $730 $640 – $730 $530 – $640 $290 – $530
Cortez Up to $1,290 $1,200 – $1,290 $1,100 – $1,200 $860 – $1,100
Craig Up to $1,320 $1,230 – $1,320 $1,130 – $1,230 $880 – $1,130
Denver Up to $740 $650 – $740 $550 – $650 $300 – $550
Fort Collins Up to $830 $740 – $830 $640 – $740 $400 – $640
Grand Junction Up to $1,080 $990 – $1,080 $890 – $990 $640 – $890
Greeley Up to $830 $740 – $830 $640 – $740 $400 – $640
Pueblo Up to $810 $730 – $810 $620 – $730 $380 – $620
Springfield Up to $1,000 $910 – $1,000 $810 – $910 $570 – $810
Sterling Up to $1,020 $930 – $1,020 $830 – $930 $590 – $830

 

Let Us Help You

We understand this is complicated which is why we have a state-wide network of certified experts to help you. You can schedule an appointment for free with one of our certified community-based Assisters or Brokers. Assisters can help you enroll in a plan, while Brokers are trained to help you sort through the plans so you make the best selection for your specific health needs and budget. Meet with an Expert.

 

Frequently Ask Questions

How do I apply for Premium Tax Credits?

If you or someone in your household no longer qualify for CHP+, we will automatically assess your eligibility for financial help in the form of Premium Tax Credits and Cost-Sharing Reductions without you having to submit a separate application. When your CHP+ benefits end, we will let you know if you qualify and for how much. Don’t worry, you will not have to fill out a separate application to determine if you are eligible.

If you do not already have a Connect for Health Colorado account, now is a good time to create one. Even though you do not need to complete a new application, if you receive a letter in late December telling you your CHP+ coverage will be ending, you will still need to select a plan through our website, and pay your first month’s premium in order to have health insurance through Connect for Health Colorado.

Note: It is important to make sure all of your information is correct, including the information for members of your household, your address, annual income, and whether you have access to or are enrolled in other health insurance. If you think you need to update your information, you can log into your Connect for Health Colorado or PEAK account, and click on “Report My Changes,” or contact the case worker listed on your most recent eligibility notice letter, which can be found in the “Communications” tab in your PEAK account.

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When can I select a plan through Connect for Health Colorado?

If Congress does not renew federal funding for CHP+ by late December 2017, you will get a letter telling you that your CHP+ coverage will only be available through January 31, 2018. The letter will also tell you if you qualify for financial assistance to help purchase private health insurance through Connect for Health Colorado. If you qualify for financial assistance to purchase private insurance through Connect for Health Colorado, you can start shopping as soon as you receive the December letter.

If you select a plan before January 31, 2018, your plan can start as early as February 1, 2018. It is important to select your plan by January 31st to avoid having a gap in coverage. If you select a plan on or after February 1, 2018, your coverage will start the first of the following month after you selected your plan. For example, if you select a plan on February 20th, your plan will start on March 1st.

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How can I determine the amount of Premium Tax Credits for which I qualify?

The amount of Premium Tax Credit you may qualify for is based on your age, income, and where you live. If Congress does not act to reauthorize funding for the CHP+ program, we will notify you in late December of the amount of Premium Tax Credit you can receive after your CHP+ benefits end.

Note: It is important to make sure all of your information is correct, including the information for members of your household, your address, annual income, and whether you have access to or are enrolled in other health insurance.

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How do I know if I qualify for Premium Tax Credits or Cost-Sharing Reductions?

To qualify for Premium Tax Credits or Cost-Sharing Reductions you must:

  • Be a Colorado Resident
  • Be Lawfully present or a U.S. citizen
  • Be a member of a household that files a federal income tax return for the year in which you receive Premium Tax Credits. If you are married, you must be married filing jointly to qualify for Premium Tax Credits, unless you have exceptional circumstances.
  • Have annual income below 400% of the Federal Poverty Level for Premium Tax Credits – see graphic below
  • Have annual income between 100-250% of the Federal Poverty level for Cost-Sharing Reductions
  • Not have other health insurance

Graph: Eligibility for financial help based on household size and annual income

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What if I have access to other health insurance, such as insurance through my job?

In order to qualify for Premium Tax Credits, you must not be enrolled in or have access to health insurance, including affordable health insurance through an employer. If the insurance offered by the employer is not considered affordable, you may qualify for Premium Tax Credits. Learn more about how to determine if your employer sponsored insurance is considered affordable.

Note: If you have access to or are enrolled in other health insurance, make sure you update your information. If you don’t tell us that you have access to or are enrolled in other health insurance, and you receive Premium Tax Credits, you may be responsible for paying back a portion of the Premium Tax Credit amount you receive when you file your income tax return.

To update your information, you can log into your Connect for Health Colorado or PEAK account, and click on “Report My Changes,” or contact the case worker listed on your most recent eligibility notice letter, which can be found in the “Communications” tab in your PEAK account.

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What if I am already enrolled in a plan through Connect for Health Colorado and my child loses CHP+?

The loss of CHP+ benefits will open a Special Enrollment Period for your child to seek coverage through Connect for Health Colorado. If you have already enrolled in a health plan, you can add your child on to your plan up to 60 days after his or her CHP+ benefits end, or you can select a separate plan for your child. In some cases, your entire household may be able to select a new plan.

For questions about this Special Enrollment Period, please contact our Customer Service Center at 855-PLANS-4-YOU or 855-752-6749. If you have previously worked with a certified Broker or Assister, please contact that person because he/she is best equipped to help you to enroll in a new plan if you qualify. We also provide a statewide network of free expert help to review your options and make sure you do not have a gap in coverage.

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What plan options are available?

You may qualify for Cost-Sharing Reductions if your annual income and household size meet the following limits:

  • Household of 1 with an annual income of no more than $30,150
  • Household of 2 with an annual income of no more than $40,600
  • Household of 3 with an annual income of no more than $51,050
  • Household of 4 with an annual income of no more than $61,500

This form of financial help can reduce the amount you are responsible for paying toward your medical costs each year. Before enrolling in a plan, check to see if your household qualifies for Cost-Sharing Reductions. If you do, you should consider enrolling in a Silver level plan to maximum your savings.

To review your plan options, use our Browse Plans tool. Or, schedule an appointment with one of our certified experts for free.

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What if I want to keep the same doctor for my child?

If you have a preferred doctor that you would like to keep, it is always best to check with the health insurance company of the plan you are considering to ensure your doctor is covered. If a doctor is in-network (covered) by one health insurance company’s plan, do NOT assume the he/she is covered by ALL plans offered by that health insurance company.

If you prefer to receive free in-person help, such as a meeting with a broker, they may be able to help you evaluate your options.

Health Insurance Company Customer Service Phone Number
Anthem (855) 453-7031
Anthem – Small Business (855) 453-7032
Bright Health (844) 691-6150
Cigna – Billing & Eligibility (877) 900-1237
Cigna – Claims & Benefits (800) CIGNA24 or (800) 244-6224
Delta Dental (800) 610-0201
Dentegra (800) 471-0284
Elevate by Denver Health Medical Plan (855) 823-8872
Friday Health Plans (800) 475-8466
Kaiser Permanente (800) 632-9700
Rocky Mountain Health Plans (855) 830-1564

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