Individual Medical Insurance Looking for Short Term? Click Here!

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, 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, it is likely you will be approved:

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

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

Other Alternatives

Cover Colorado: www.covercolorado.org

Is a state run plan that provides health insurance to individuals with pre-existing medical conditions. If you have been denied health insurance due to a pre-existing medical condition, or have exhausted your COBRA benefits, we may be able to help. While CoverColorado is not a low income plan, this may be your best option if you are unable to obtain coverage elsewhere and can afford it. CoverColorado also offers a Coordination of Benefits plan to those disabled individuals under age 65 who cannot purchase Medicare supplement policies outside the open enrollment period. Participants are not subject to a waiting period, so coverage for all health conditions is available to qualified applicants upon approval into the plan.

GettingUSCovered: www.gettinguscovered.org

GettingUSCovered provides health care coverage to individuals unable to purchase comprehensive health insurance because of a medical condition. GettingUSCovered is the federal high risk pool established in the State of Colorado under the Patient Protection and Affordability Act of 2010. It is funded by federal dollars and member premiums which is the first step in national health care reform. Rocky Mountain Health Plans (RMHP), a locally-owned, Colorado-based nonprofit organization, has contracted with the federal Department of Health and Human Services to administer GettingUSCovered. Enrollment may need to be limited based on federal funding. The plan is a bridge to 2014, when individuals with pre-existing conditions will be able to purchase health coverage through health insurance exchanges.

What are the key benefits of GettingUSCovered?

• Comprehensive medical coverage for individuals with health conditions that prevent them from getting insured:
  • Primary and specialty health care
  • Mental health coverage
  • Nationally recommended preventive care services
  • Prescription drug coverage
• Access to one of the largest network of physicians in the state

Child Health Plan Plus (CHP+): www.cchp.org/

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.

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.

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), HSA (Health Savings Account) or HSA compatible, and HMO (Health Maintenance Organization).

A PPO allows members to choose doctors from a wide network of physicians and hospitals. Members make a copay for Office Visits and Prescription Drugs without being subject to a deductible. The member's deductible will apply to all other services.

An HSA also allow members to choose doctors from a wide network. In an HSA 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 a percentage (either 100% or 80%, the member's choice). We usually recommend the 100% option. The benefit of an HSA is that members may place their deductible or IRS Maximum (whichever is less) into this account tax-free to use for medical expenses.

An HMO is a managed care organization that combines the function of insurance company and health care provider. Members select a primary care physician (PCP) from the participating physician network. The PCP, acts as the member's personal physician, and 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-pays, and do not have to file their own claims. Kaiser is America's largest not-for-profit HMO.

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