INDIVIDUAL MEDICAL INSURANCE

If you are currently without medical insurance and are looking for comprehensive long-term coverage, an Individual Medial Policy may be the best option for you. You are eligible to apply for an Individual policy if you are a Colorado resident under the age of 65.

Am I Eligible?
Any Colorado resident under the age of 65 is eligible to apply for Individual coverage, but approval is not guaranteed. All applicants must answer questions about their health history and prescription drug regimen. The insurance carrier will approve or deny coverage based on this information.

Will I be approved?
If you answer "No" to all of the following questions, you will most likely be approved:

1. Have you ever had any major physical or mental illness?
2. Have you ever tested positive for HIV or the AIDS virus?
3. Do you currently take any medications other than birth control on a regular basis?
4. Have you undergone any major medical event such as surgery in the last 10 years?
5. Are you planning any major medical service or testing in the future?
6. Are you currently being treated for any on-going health related injury or illness?
7. Have you ever been denied Health Insurance?

If you answered "Yes" to any of these questions, you may still have an opportunity to obtain benefits. If the illness or injury is over 5 years ago and completely resolved, Insurance Carriers might consider your application for approval.

Cover Colorado
If you are not a candidate because of health conditions, the State of Colorado has an agency that offers insurance to those who are not eligible for Individual coverage. Please visit www.covercolorado.org for more information.

Child Health Plan Plus (CHP+)
CHP+ is a low-cost health insurance program for uninsured Colorodo children ages 18 and under whose families earn too much to qualify for Medicaid but cannot afford private insurance. Please visit www.cchp.org/ for more information.

Next Step - Apply for Coverage
To obtain a quote and apply for coverage, visit the links for individual options as indicated. You may obtain quotes, view plan designs, and apply for coverage. If at any point you have trouble with this process, please do not hesitate to contact our office.

Individual Health Insurance

Individual Health Insurance - Child Only

Individual Health Insurance - Temporary

Individual Dental Insurance

Medicare Supplements

Applications

Providers

FAQ

Term Life

Choosing a Plan
Individual medical policies vary a great deal from traditional Group Health Insurance. Medical policies are usually divided into three distinct types:

• PPO: Preferred Provider Organization - These plans allow members to choose doctors from a wide network of physicians and hospitals. This type of policy offers the member the ability to pay a copay for Office Visits and Prescription Drugs without being subject to a deductible. The member's deductible will apply to all other services.
• HSA: Health Savings Account Compatible - These plans allow members to choose doctors from a wide network of physicians and hospitals. Under this plan, all medical services (including office visits and prescription drugs) are subject to an annual deductible of the member's choice. After the deductible is satisfied, the Insurance Carrier will begin paying at the percentage of the member's choice (either 100% or 80%). We often recommend that our clients choose the 100% option. The benefit of this plan is that members and families will be eligible to open a HSA, or Health Savings Account. The member may place their deductible or IRS Maximum (whichever is less) into this account tax-free to use for medical expenses.
• HMO: An HMO is a managed care organization that combines the function of a health insurance company and a health care provider. A covered member selects a primary care physician (PCP) from the participating physician network when enrolling in an HMO. The PCP, who acts as the member's personal physician, manages the member's health care, including referrals to select specialists, and admission to hospitals, except in the case of a life-threatening emergency. Members pay minimal co-payments, and do not have to file their own claims. Kaiser is America's largest not-for-profit HMO, serving 8 million members in 11 states and the District of Columbia. Kaiser Permanente is an integrated health delivery system that organizes and provides or coordinates members' care, including preventive care, immunizations and screening diagnostics, hospital and medical services, and pharmacy services.

If you need help deciding which plan fits your lifestyle, please contact out office.

Important Facts

• Most Individual Plans do not cover Maternity. This means that no maternity related claims will be covered.
• Anthem BCBS Plans do not cover preventive care. Children are allowed well visits and immunizations according to a schedule dependent on age. Females over a certain age have access to a mammogram and one OBGYN visit per year. Men over a certain age have access to one prostate exam per year. No other preventive benefits are allowed or covered. This means that all other services must be medically necessary and might be subject to deductible.
• If you have not had coverage continuously in the past 12 months (no gap more than 60 days), pre-existing conditions will not be covered under your plan for the first 6 months of coverage.
• Individual plans must be paid through an individual checking account. Payment through a business account is prohibited by law and is not deductible on a business tax return.