Customer Service: #1-877-461-3811
Help Line/Prior Authorization: #1-800-788-7871
Applicant must have either been denied health insurance coverage; issued a rate higher than a COVER Colorado rate; policy issued with exclusion riders; or have a health condition listed for automatic eligibility.
Application Cut-Off Dates
Complete Application must be submitted on-line prior to the 15th of the month in order for coverage to go into effect on the 1st of the following month. If the 15th falls on a weekend, the application deadline is the previous Friday.
Apply on line; but you must send original application and check.
8 Plans Available
Deductible is the amount you must pay before benefits are paid. There are some benefits paid that are not subject to deductible such as Preventative and Prescription Drugs. The Out of Pocket includes the deductible. The deductible is calendar year and starts over each calendar year regardless of when you became insured.
Pre-Existing Conditions will be covered in the effective date if you have been insured for at least six continuous months and apply within 90 days. If no prior insurance, you will be subject to a six month waiting period for the pre-existing condition.
Rates typically change January 1st and July 1st each year. Age change can also cause rate increase.
Applicant must live in Colorado for 6 months unless transferring from a prior state High Risk Pool.
See RX formulary on-line.
Generic: Plan pays 80%, you pay 20% (Not subject to Deductible)
Brand Name: Plan pays 60%, you pay 20% (Not subject to Deductible)
Non-Formulary: You must get prior authorization: Plan pays 40%, you pay 60%
If you have an HSA plan, RX is paid after deductible.
If you are Self-Employed, Work Related Injuries are Not Covered!
Most health policies cover 24 hour coverage for people that are self-employed. Normally owners do not purchase Workers Compensation Coverage. With Cover Colorado, if you are self-employed it would be necessary to purchase WC in order to cover the exposure to a work related injury.
If you are denied because you are pregnant, and you have no prior insurance, there is a 6 month waiting period for the pregnancy.
If you have an individual health policy for less than 60 days, you may qualify.
If you have an individual policy more than 60 days old, you are not eligible.
If you have a group health plan that does not offer COBRA, plan terminated, if pregnant, you must apply to individual health carrier and get denial.
List of Presumptive Disabilities
If you have any of these illnesses, you must either provide a doctor’s letter or have been denied. Most individual health carriers will quickly deny you and provide a denial letter to submit to Cover Colorado. As your Broker, we can help you facilitate this process.