Colorado Governor Bill Ritter unveiled details about the new high risk pool today, and more information is available online at the program’s website, GettingUsCovered. The existing Cover Colorado website has also been expanded to include information about the new program.
Cover Colorado has been the safety net plan for Colorado residents with pre-existing conditions for years. But it isn’t the best fit for everyone, and the new federally-funded program will help to fill the gaps. For example, Cover Colorado imposes a six month pre-existing condition waiting period on any applicant who has not had health insurance coverage for 90 days or more prior to applying for Cover Colorado. The new high risk pool does not have pre-existing condition waiting periods, but is only available to people who have been uninsured for at least six months. A person who has been uninsured for six months or more (and has a pre-existing condition that prevents them from qualifying for private health insurance) has always had the option of applying for coverage with Cover Colorado. But the new program will be a better solution, as there would not be a pre-existing condition waiting period. Interested applicants can visit the Cover Colorado homepage for a simple four question survey that will direct them to either Cover Colorado or GettingUSCovered, depending on their answers.
With the exception of the six month uninsured period, the eligibility requirements for GettingUsCovered are very similar to Cover Colorado’s. Applicants must be legal US and Colorado residents, and must provide either a letter of denial from a private health insurance carrier, or a letter of acceptance with reduced benefits or exclusion riders. Alternatively, an applicant automatically qualifies if he or she has one of these medical conditions, which is the exact same list that Cover Colorado uses.
To get an idea of how pricing compares, I ran a quote for myself on the GettingUSCovered site ($201/month for a $2500 deductible plan with a maximum out of pocket of $5950/year, including the deductible) and on Cover Colorado’s site. Cover Colorado has several deductible options to choose from, but I looked at the $3000 deductible plan, which has a maximum out of pocket exposure of $6000 (Cover Colorado does not have a $2500 deductible, but the out of pocket exposure on this policy is very similar to that of the $2500 GettingUSCovered plan). GettingUSCovered is not income-dependent, and thus has just one price. Cover Colorado offers discounts if applicants have household incomes below $50,000. The $3000 deductible plan would cost between $191 and $267, depending on my income.
I also got quotes for myself using our quote engine to compare prices from all of the major private health insurance carriers in Colorado, and got prices ranging from $90/month to $183/month (for plans with $2500 deductibles and $30 or lower office visit copays). The private plans are less expensive and have higher lifetime maximum benefits, but for the time being (until 2014) they are only available to people who are relatively healthy.
It’s nice to see Colorado leading the way in terms of using the federal high risk pool money to set up a new program for people with pre-existing conditions. Whether the money will hold out until 2014 remains to be seen, but at least we are now well on our way to having one more option for people in Colorado who can’t qualify for private health insurance.