Early Retiree, Business Owner, and others Under 65, without employer or governmental insurance.
Navigating the maze of health insurance options for people under 65
Bridge to Medicare
No employer insurance, too young for Medicare, too old to be on your parents’ plan? You need individual health insurance.
The most comprehensive coverage for individuals and families not on employer or governmental plans, are those that comply with the requirements of the Affordable Care Act (ACA). This means:
• No pre-existing condition limitations
• No annual or lifetime benefit payout maximum
• Annual cap on your out of pocket expenses
• Annual wellness exams and tests at no out of pocket cost.
None of the insurance companies selling ACA plans within Colorado offer a PPO option (i.e., no out of state or out of network benefits). However, all ACA plans must cover emergency room benefits anywhere in the US
Short Term Options
If you missed open enrollment for ACA plans or just need short -term minimum coverage, we have options available. We discuss the pros and cons of each option so you know exactly what you are and are not buying.
For anyone Under 65, without full benefit health insurance:
Starting a Company.
Laid off or taking a break
Waiting for new job coverage to start
Income over Medicaid cutoffs
plans are “good insurance.”
No pre-existing condition limitations.
Rates are based only on age and zip code. The insurance companies must take you as you are.
No annual or lifetime benefit payout maximum.
The insurance companies must pay your covered benefits no matter how expensive it gets for them.
Annual cap on your out-of-pocket expenses
Once you pay out the specified amount, insurance pays 100% for the rest of the year.
Annual wellness exams and tests at no cost.
Physical exam and tests to give you an annual view of your health and wellbeing.
Emergencies covered anywhere in the US.
Emergency room and urgent care visits covered anywhere in the US as if in network for your plan.
Over 50? These plans are your Bridge to Medicare
Advanced Premium Tax Credits (APTC)
This benefit is to make the monthly premium more affordable for an individual or family. If you qualify for a tax credit, a monthly share of the estimated tax credit is paid to your insurance company against your premium. Then, you pay the balance.
Eligibility is based on annual estimated income, family size and zip code. Expanded eligibility since COVID make this benefit available to more people than ever.
Example: Married couple each aged 53, living in Denver, with joint annual income $100,000. would be eligible for a $330 per month discount on their monthly insurance premiums. Let me check your eligibility.
* An ACA-Compliant plan meets the minimum standards required by the Affordable Care Act (ACA) and supports the extra help provided by the law.
Short Term Options
If you missed open enrollment for ACA plans and don’t qualify to enroll during the calendar year, some health insurance options are available. I will discuss the pros and cons of each option, so you know exactly what you are and are not buying.