You’ve got your health insurance. Now what?
Getting enrolled is just the first step. Understanding how to use your plan—what’s covered, what your benefits are, and how life changes might affect your coverage—can feel overwhelming. That’s where we come in.
Below, you’ll find helpful links and videos that answer many of the questions our Health Coverage Guides and Enrollment Navigators hear every day. Some resources were created by our team, while others come from trusted organizations like Health & Human Services. Most materials are available in both English and Spanish.
Some resources may include contact information for outside organizations, but you’re always welcome to reach out to us—your local resource—for personalized support at 970.708.7096.
GENERAL QUESTIONS & HEALTH INSURANCE LITERACY
Q. Does Obamacare and the Affordable Care Act (ACA) work the same way?
A. Yes. The Affordable Care Act was signed into law by President Obama on March 23, 2010. It’s nickname is Obamacare.
Q. What is the purpose of Open Enrollment?
A. Open enrollment exists to incentivize individuals to keep an insurance plan, not risk being uninsured, and minimize switching between cheaper and expensive plans at the individual’s convenience. If everyone does not pay their fair share, premiums go up for everyone in order to cover a sick person’s medical expenses.
Q. What is a “Qualifying Life Change Event” or “Special Enrollment Period?”
A. A qualifying life change event opens up a special enrollment period so people, outside of open enrollment, can enroll in health insurance. These qualifying life change events include but are not limited to: loss of job, loss of health insurance, marriage, adding a child to the household, etc. When a life change event occurs, you should contact your local Health Coverage Guide, 970-708-7096, or Connect for Health Colorado Customer Service at 1-855-PLANS-4-YOU (1-855-752-6749) to report the event and make any necessary changes to your policy. You must report this change within 60 days of the qualifying event. To read more about qualifying life change events, click here.
¿Qué es un “Evento de Cambio de Vida Calificado” o un “Período de Inscripción Especial?”
R. Un evento de cambio de vida calificado abre un período de inscripción especial para que las personas se puedan inscribir en un seguro de salud fuera del Período de Inscripción Abierta. Estos eventos de cambio de vida calificados incluyen, pero no están limitados a: pérdida de trabajo, pérdida de seguro de salud, matrimonio, añadir un hijo al hogar, etc. Cuando un evento de cambio de vida ocurre, usted debe contactar a su Guía de Cobertura de Salud local al 970-708-7096, o a Servicio del Cliente de Connect for Health Colorado al 1-855-PLANS-4-YOU (1-855-752-6749) para reportar el evento y hacer cualquier cambio necesario a su política. Usted debe reportar este cambio dentro de 60 días del evento calificado.
Q. What are “Essential Health Benefits?”
A. A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services. Plans must offer dental coverage for children. Dental benefits for adults are optional. Specific services may vary based on your state’s requirements. You’ll see exactly what each plan offers when you compare plans.
Q. What are “Preventive Benefits?”
A. Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems. Most health plans must cover a set of preventive services — like certain shots and screening tests — at no out-of-pocket cost to you. This includes plans available through a Health Insurance Marketplace and is true even if you haven’t met your yearly deductible. Note: to receive these services at no additional cost, make sure to get them from a doctor or other provider in your plan’s network. For a comprehensive live of adult preventive benefits, click here. For children, click here.
Q. What is Federal Poverty Level (FPL)?
A. FPL is a measure of income issued every year by the Department of Health and Human Services (HHS). FPLs are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHP+ coverage. The current year’s federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHP+). To learn more, click here.
Q. Can you help me understand insurance terms like premium and co-pay?
A. If you are baffled by premiums, deductibles and out-of-pocket maximums, understanding basic insurance terms will take you a long way in understanding how your health insurance works. This short video by TCHNetwork will help you better understand these basic terms. If you still have questions, call us — we’re here to help! Click here for our short video.
Q¿Me puede ayudar a entender términos de seguro, como cuota y copago?
R. Poder entender los términos básicos de seguros te ayudará a entender cómo funciona tu seguro de salud. Este video presentado por TCHNetwork te ayudará a entender estos términos básicos. Si es que todavía tienes preguntas, llámanos – ¡estamos aquí para ayudarte! Haz clic aquí para nuestro corto video.
Q. Who is in my plan’s Network? Why is this important?
A. Your insurance company contracts with medical providers, facilities and suppliers. Generally you will pay less if you use providers, facilities or suppliers in your plan’s network. Networks can change during the life of your plan. Check your Summary of Benefits or call your insurance company if you have more questions. Click here for a short video.
Q. How does my health insurance cover prescription drugs?
A. The amount you pay for your prescriptions will depend on the health insurance plan you select. Before selecting a plan, make sure you understand how your prescription is listed. Click here for a short video about prescription drug coverage.
Q. I will be turning 65 in October. Do I keep my insurance plan until the end of the year? What do I need to do to sign up for Medicare?
A. No. You will need to sign up for your Medicare with the social security administration and decide if you would like a supplemental plan through a company of your choice. A good local resource is Region 10 at 888-696-7213. They have information on all the Medicare plans and a list of companies available. You have 3 months before and 3 months after you turn 65 to sign up for Medicare.
Q. What is Tricare?
A. Tricare is the military’s health insurance program, and it comes in four varieties: Tricare Prime, Tricare Extra, Tricare Standard, and Tricare for Life. Tricare covers everyone — active-duty members, retirees, and their families. However, retirees and their dependents have to chip in for the cost of coverage.
COLORADO’S INSURANCE MARKETPLACE – Connect for Health Colorado
Q. Is there a way to calculate my potential savings and narrow down my preferences for choices of coverage?
A. Yes. You can check if you’re eligible for financial assistance to help lower your monthly costs (including Medicaid and CHP+) and view plans that include your preferred doctors, hospitals/facilities, and medications.
Q. Why is it important to report a change in my income?
A. Your eligibility for specific programs may change based on your income. You might fall in or out of Medicaid eligibility, or your tax credits might increase or decrease could possibly result in a penalty. Your tax liability at the end of the year could be in jeopardy based on whether or not you accurately report your income. [AJ1]
Q. I have not received a bill from my insurance carrier. How do I pay my premium?
A. 1. Contact Connect for Health Colorado to determine if your enrollment information was sent to the insurance carrier. 2. If not, ask them to guarantee the “start date” of your plan – ask for an incident/tracking number to document this phone call. 3. If they determine that your information was correctly sent to your insurance carrier, ask for an incident/tracking number to document this phone call. 4. Contact your insurance carrier and let them know that you have not received an invoice and that you need to pay your first bill (referred to as a binder payment). You must do this before the 1st of the month that your insurance begins coverage. Without this payment, your insurance carrier can cancel your insurance coverage. Ask them for a tracking number to document this phone call. 5. Ensure that your insurance carrier has the correct mailing address for future correspondences.
Q. What are Advanced Premium Tax Credits ?
A. Advanced Premium Tax Credits (APTC) are granted to people based on their family size and household income. APTCs lower a plan’s monthly premium and can be used to purchase any plan on the Marketplace.
Q. I’m turning 26 this year and am losing coverage through my parents. What should I do?
A. If you have health insurance under your parent’s plan and are turning 26 this year, you have coverage options. Your choices will depend on whether your parent’s plan is through their job or Colorado’s health insurance marketplace, Connect for Health Colorado.
Cumplo 26 este año y pierdo cobertura bajo mis padres. ¿Qué debo hacer?
R. Si tienes seguro de salud bajo el plan de tus padres y cumples 26 este año, tienes opciones para cobertura. Tus opciones dependerán de si el plan de tus padres es por medio de su trabajo o el mercado de seguros de salud de Colorado, Connect for Health Colorado.
Q. My child is turning 19 this year and losing CHP+ coverage. What should I do?
A. You need to contact your local health coverage guide (970-708-7096) before the 15th of the month that your child turns 19. This will ensure an effective date on the 1st of the following month, thereby avoiding a lapse in coverage for your child.
Q. I just lost my employer-sponsored health insurance coverage. Can I enroll in the Marketplace?
A. Yes, and You may even qualify for Medicaid. On the marketplace, you have a 60-day Special Enrollment Period to enroll in health insurance. To avoid a gap in your coverage, enroll before the 15th of the month you are losing your employer-sponsored coverage.
Q. I am insured through the Marketplace but recently qualified for Medicaid. Do I need to cancel my marketplace plan?
A. Yes, and TCHNetwork can help to submit your application for Medicaid! Contact your local health coverage guide and immediately cancel your health insurance – ask for an incident number to track this request. You will be given an end-of-month termination date. If you already paid for your current month of coverage, continue to use it until the end of the month; then begin to use your Medicaid the following month.
Q. Since my health insurance was not canceled until the end of the month but I qualified for Medicaid at the beginning of the month, will I have to pay back my tax credits?
A. No. The Internal Revenue Service (IRS) states that individuals who are receiving advance premium tax credits and are determined to be eligible for Medicaid on a retroactive basis do not have to pay them back. They are treated as eligible for minimum essential coverage no earlier than the first day of the first calendar month after the Medicaid application’s approval. The IRS rules have a helpful example to illustrate this: Julia is receiving advance payments when she loses her part-time job. She applied for Medicaid on April 10, 2026. Her application is approved retroactive to April 1, 2026. Based on this, Julia is not considered to have minimum essential coverage until May 1, 2026, the first day of the calendar month after approval of her Medicaid application.
Q. I turn 65 in September. When do I cancel my Marketplace plan?
A. It is best to cancel your marketplace plan one month in advance of the month you turn 65. For example: if you turn 65 on September 22, then your Medicare will start September 1. You will need to cancel your marketplace plan between August 1 and August 15 to be terminated by August 31.
COLORADO MEDICAID (HEALTH FIRST COLORADO)
* On December 29, 2025, a U.S. District Court judge ruled that as of January 6, 2026, the Centers for Medicare & Medicaid Services (CMS) may share limited Medicaid information with ICE, including data obtained from Colorado. CMS may only provide data to ICE if the data 1) is from the Medicaid program only, 2) pertains only to individuals who are not lawfully residing in the U.S., and 3) only includes citizenship and immigration status, address, phone number, date of birth, and Medicaid ID. Until further notice, CMS is prevented from sharing data that goes beyond these categories and ICE may not use data obtained from CMS unless it falls within this limited scope.
Important Note: CMS does not require states to submit data for members who receive state-only funded benefits, and states are responsible for separating the data when submitting it to CMS. HCPF confirmed that the information of children enrolled in benefits through Cover All Coloradans is not shared with CMS since this population is fully funded by the state of Colorado. The only scenarios where this information would be shared with CMS is if the child is pregnant or the child received emergency services, and the services were paid through Emergency Medicaid.
Additionally, SilverEnhanced Savings through the OmniSalud program are state-funded no data is shared to CMS.
CHILD HEALTH PLANS PLUS (CHP+ or CHIP)
Rocky Mountain Health Plans FAQ page
CITIZENSHIP & HEALTH INSURANCE
Q. If I apply for health insurance, how is my information used?
A. Information about immigration status will be used only to determine eligibility for coverage and not for immigration enforcement.
Si solicito seguro de salud, ¿Cómo será usada mi información?
R.La información sobre el estatus migratorio será usada sólo para determinar su elegibilidad para cobertura médica y no por la ley de inmigración.
Q. What citizenship statuses qualify for insurance?*[JR1] [AR2]
A. Immigrants with the following statuses qualify to use the Marketplace:
1. Lawful Permanent Resident (LPR/Green Card holder)
2. Cuban/Haitian Entrants
3. COFA Migrants (citizens of Micronesia, Palau, or the Marshall Islands that are allowed to live and work in the United States under the Compacts of Free Association)
¿Qué estatus de ciudadanía califican para un seguro de salud?
R. Los inmigrantes con los siguientes estatus califican para usar el Mercado de Seguros:
1. Residente permanente legal (LPR/Portador de una tarjeta de residente permanente)
2. Participante Cubano-Haitian
3. COFA ( Ciudadanos de Micronesia, Palau o de Islas Marshall que tienen permiso de vivir en Estados Unidos bajo Compacto de Asociación Gratis)
Q. I am a legally present immigrant. I have a green card. Can I get health insurance?
A. An immigrant that is legally present (has a green card) for less than 5 years and does not qualify for Medicaid or CHP+ might qualify for lower cost health insurance through the Colorado’s insurance marketplace. As an immigrant, navigating health insurance in the United States can be difficult, but Tri-County Health Network will help you understand the health insurance options available to you and your loved ones.
Soy un inmigrante con residencia legal. Tengo una tarjeta verde. ¿Puedo obtener seguro de salud?
R. Como inmigrante, puede ser difícil navegar los seguros de salud en los Estados Unidos, pero Tri-County Health Network te ayudará a entender las opciones disponibles para ti y tus seres queridos con respecto a la cobertura médica.
Q. I am not a legal permanent resident and I do not meet the citizenship status criteria. Do I have any options for insurance coverage?
A. You can purchase health insurance through Connect for Health Colorado or a licensed insurance broker but you cannot qualify for subsidized coverage through the Affordable Care Act, through Medicaid or CHP+.
No soy un residente legal permanente y no cumplo con los criterios de estatus de ciudadanía. ¿Tengo algunas opciones para cobertura médica?
R. Puedes comprar cobertura médica en Connect for Health Colorado o por medio de un corredor de seguros calificado, pero no puedes calificar para cobertura subsidiada mediantela Ley de Cuidado de Salud Asequible.
Q. What is a Qualified Non-Citizen?
A. The term “qualified non-citizen” includes:
1. Lawful Permanent Residents (LPR/Green Card Holder)
2. Asylees
3. Refugees
4. Cuban/Haitian entrants
5. Paroled into the U.S. for at least one year
6. Conditional entrant granted before 1980
7. Battered non-citizens, spouses, children, or parents
8. Victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa
9. Granted withholding of deportation
10. Member of a federally recognized Indian tribe or American Indian born in Canada
¿Qué es un No Ciudadano Calificado?
R. El término “no ciudadano calificado” incluye a:
1. Los residentes permanentes legales (LPR/con la tarjeta verde)
2. Asilados
3. Refugiados
4. Inmigrantes Cubanos/Haitianos
5. Permiso condicional para estar en los EE.UU. al menos por un año
6. Ingreso condicional otorgado antes de 1980
7. Cónyuges, hijos y padres abusados que no son ciudadanos
8. Víctimas del tráfico humano/de personas y sus cónyuges, hijos, hermanos o padres, o individuos con una solicitud pendiente para una visa de víctima de tráfico humano
9. Personas a las que les han interrumpido la deportación
10. Miembro de una tribu indígena reconocida federalmente o Indio-americano nacido en Canadá.
I am a Qualified Non-Citizen. Do I qualify for health insurance programs?
A. Yes. You are subject to Medicaid/CHP+ and Marketplace income guidelines that will determine your eligibility for a specific program. You must have the appropriate documentation to be able to complete an enrollment.
Soy un No Ciudadano Calificado. ¿Califico para programas de seguro de salud?
R. Sí. Usted es sujeto a las pautas de ingresos de Medicaid/CHP+, que determinan su elegibilidad para un programa específico. Usted debe tener la documentación apropiada para poder completar una inscripción.
Q. I have DACA. Am I eligible for health insurance assistance programs?
A. You may qualify for emergency Medicaid or buy private health insurance but you do not qualify for cost assistance.
Tengo DACA. ¿Soy elegible para programas de asistencia para seguros de salud?
R. Usted puede calificar para Medicaid para Emergencias o comprar un seguro de salud privado, pero no califica para asistencia con costos.
Q. I have Employment Authorization. Do I qualify for health insurance programs?
A. People with the following statuses and who have employment authorization qualify for the Marketplace:
1. Registry Applicants
2. Order of Supervision
3. Applicant for Cancellation of Removal or Suspension of Deportation
4. Applicant for Legalization under Immigration Reform and Control Act (IRCA)
5. Legalization under the LIFE Act
Tengo Autorización de Empleo. ¿Califico para programas de seguro de salud?
R. Las personas con los siguientes estatus y que tienen autorización de empleo califican en el Mercado: 1. Solicitantes a través de registro
2. Orden de supervision
3. Solicitante para cancelación de remoción o suspensión de deportación
4. Solicitante para legalización bajo IRCA (Immigration Reform and Control Act)
5. Legalización bajo la Ley LIFE
What is Emergency Medicaid?
A. Emergency Medicaid is short term coverage for immigrants without legal permanent residency or Naturalization status. Emergency Medicaid only covers life and limb threatening situations, and does not cover doctor appointments or routine care. To apply you must visit your local Health & Human Services Office. Click here to find your local office. For more information contact one of Tri-County Health Network’s bilingual enrollment navigators: 970.708.7096
¿Qué es Medicaid para Emergencias?
R. Medicaid para Emergencias es cobertura de corto plazo para inmigrantes sin residencia legal permanente o estatus de naturalización. Medicaid para Emergencias sólo cubre situaciones con peligro de vida o pérdida de extremidades, y no cubre citas al doctor o cuidado de rutina. Para solicitarlo, usted debe visitar su oficinalocal de Salud y Servicios Humanos. Haga clic aquí para encontrar su oficina local. Para más información contacte a uno de los navegadores de inscripción bilingües de Tri-County Health Network: 970.708.7096
NECESSARY DOCUMENTS FOR FILING YOUR INCOME TAXES
Employees of Tri-County Health Network are not tax accountants. We can, however, offer you the following information regarding the documents you will need when reconciling your taxes:
1095A – This document is necessary to reconcile your taxes if you received a Marketplace tax credit. You will find it in the MY DOCUMENTS folder of your connectforhealthco.com account. If this form is not found in MY DOCUMENTS, contact Connect for Health Colorado at 1.855.752.6749.
1095B – This document proves that you were enrolled into a qualified health plan for the tax year. You will receive this document from Medicaid/CHP+ or your health insurance carrier. If you do not receive this document, contact your local Health and Human Services office.
1095C – This document is necessary if you receive employer sponsored health coverage. Your employer will supply this document.
CONTACT INFORMATION FOR ASSISTANCE
Tri-County Health Network (TCHNetwork) provides insurance enrollment and education assistance for Colorado’s marketplace (Connect for Health Colorado), Health First Colorado (Medicaid), and Child Health Plans Plus (CHP+ or CHIP). Below, find contact information for assistance by organization:
TCHNetwork Health Coverage Guide, click here. You can also contact TCHNetwork directly at 1.970.708.7096.
Connect for Health Colorado: 1.855.752.6749 or click here.
Health First Colorado (Medicaid): 1.800.221.3943 or click here.
San Miguel County Health and Human Services: 1.970.728.4411
Ouray County Human Services: 1.970.626.2299
Child Health Plans Plus of Colorado (CHP+): 1.800.359.1991, the mailing address is Department of Health Care Policy & Financing, P.O. Box 17548, Denver CO 80217
Rocky Mountain Health Plans: 1.800.346.4643
