Boulder County Enrollment Center

Changes in Financial Help for 2026 Connect for Health Colorado Plans

 Cost-Sharing Reductions (CSRs) Are Changing

• Fewer people will qualify for CSRs (which help reduce out-of-pocket costs like copays and deductibles).
• CSRs are going back to federal levels, which are lower than they’ve been in the past few years.

New: Colorado Premium Assistance (CPA)

• CPA will give flat monthly discounts to people with incomes between 0–400% of the Federal Poverty Level (FPL) who qualify for premium tax credits.
• It will give:
  • $80 per month for the first household member
  • $29 per month for each additional household member
• This money won’t count as income and doesn’t need to be reported or filed with taxes.

What You Can Do

• Schedule an appointment with our team (programe una cita en español con nuestro equipo) to talk through your options.
• Appointments will fill quickly — book for November and December now.

OmniSalud

What’s changing for 2026:

• 6,700 $0 plans will be available statewide. This is a 44% reduction in spots for plan year 2026.
• There will be a lottery to determine who can re-enroll in $0 plans. Current enrollees who are not selected in the lottery can enroll in a full-price plan.
• $0 plans will move from 94% actuarial value to 73%. This means that you will pay more out of pocket when using your medical coverage.
• There is no limit on full-price plans, which are available to anyone through Colorado Connect.

Re-Enrollment for Current OmniSalud Members:

• Open Enrollment is not automatic. You must log in and re-apply between Nov. 1-Nov. 16th.
• Key Dates:
  • Open Enrollment: Nov. 1, 2025 – Jan. 15, 2026
  • Lottery application window: Nov. 1 – Nov. 16, 2025
  • Lottery results posted: Nov. 17, 2025, after 5 p.m.
  • Second lottery drawing: Nov. 16, 2025

Lottery process for people with 2025 $0 OmniSalud plans:

1. Log in to your Colorado Connect account.
2. Submit a new application between Nov. 1 – Nov. 16 to be entered into the lottery.
3. After 5 p.m. on Nov. 17, check your Colorado Connect account under “My Documents” to see if you were selected.
4. If selected, you must enroll in a $0 plan between Nov. 17 – Dec. 15.
5. If not selected, you may enroll in a full-price plan between Nov. 17 – Jan. 15.
6. If there are leftover spots, a second lottery will happen on Dec. 16. If you weren’t chosen the first time, you’ll automatically be entered in the second drawing.

Marketplace Enrollment for Full-Price Plans :

Anyone, including undocumented community members, can apply for a full-price plan through Colorado Connect from Nov. 1, 2025 –Jan. 15, 2026 . There is no cap on how many people can enroll. Monthly costs depend on age and plan level. On average, monthly premiums for bronze plans were $350-750/month per person in 2025.

DACA Recipients

• As of Aug. 25, 2025, DACA (Deferred Action for Childhood Arrivals) recipients can’t get Connect for Health plans or premium tax credit help anymore.
• During Open Enrollment, DACA recipients should enroll in Colorado Connect instead of Connect for Health Colorado.

Medicaid for Undocumented Pregnant People and Children (0–18)

Since Jan. 1, 2025, undocumented children and pregnant people can get full health insurance coverage, even without immigration status.

Who qualifies:

• Undocumented children ages 0–18
• Undocumented pregnant people
• DACA recipients

What’s covered:

• Full Medicaid (Health First Colorado) or CHP+ (Child Health plan Plus) benefits
• 12 months of postpartum care after giving birth (if eligible)

Health insurance is a plan you buy that helps pay for medical care for you and your family.

Key Health Insurance Terms

Premium: The amount you pay monthly for health insurance.

Deductible: The amount you pay annually before your insurance begins to cover expenses.

Copay: A fixed fee you pay for specific services, such as a doctor’s visit.

Out-of-Pocket Maximum: The maximum amount you will pay in a year for covered care.

Network: The group of doctors and clinics associated with your plan. Receiving in-network care generally incurs lower costs.

Programs That Help Lower Health Care Costs

There are government programs that can make health care much more affordable. These programs depend on things like your income, age, immigration status, or job situation.

Connect for Health Colorado

• This is the state’s official place to shop for and buy health insurance.
• You may qualify for help paying costs if you don’t qualify for Medicaid or coverage through a job.

OmniSalud

• This program helps undocumented Coloradans get health insurance.
• Anyone can buy a full-price plan, but some individuals or families with household income under 150% FPL can get a special low-cost plan with a $100 deductible per year.

Medicare

For people 65 and older who worked and paid taxes for about 10 years. It offers different options for health insurance at lower cost.

Medicare Savings Program

Helps people with Medicare pay for premiums and other costs.

Medicaid (Health First Colorado) and CHP+ (Child Health Plan Plus)

These are free or low-cost health insurance programs for people who meet the eligibility criteria. They cover many services, including medical, mental health, and reproductive health care.

Emergency Medicaid

For undocumented people. Covers life-threatening emergencies and family planning services.

Hospital Discounted Care Program

Offers discounted hospital health care services to people who qualify.

Enrollment periods vary by program.

Connect for Health Colorado and OmniSalud

Open Enrollment Period:

Nov. 1 to Jan. 15 each year.

Special Enrollment Period:

You may be able to apply outside of Open Enrollment if you have a Life Change Event, like:

• Losing insurance from your job
• Getting married
• Having a baby
• Moving to a new address

Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus):

You can apply on Colorado PEAK any time during the year.

Medicare:

Open Enrollment is from Oct. 15 to Dec. 7 each year.

The Boulder County Enrollment Center does not handle Medicare enrollments.

If you need Medicare help, contact the Boulder County Area Agency on Aging. Their Medicare counselors give free, unbiased advice and can compare your current plan with other options.

We can help you:

• Apply for new health insurance
• Renew or update your current plan
• Troubleshoot issues with your account
• Answer your questions about health insurance

Programs we can help you with:

• Connect for Health Colorado
• OmniSalud
• Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus)

Connect for Health Colorado:

• Update an account or enroll on your own through Connect for Health Colorado.

Omnisalud:

• Update an account or enroll on your own for Omnisalud.

Medicaid or CHP+:

• Update an account or enroll on your own for Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus).

We offer three types of free, virtual appointments:

General Support – 30 minutes

Best for:

• Quick questions
• Reporting a simple change (like address or phone number)
• Fixing a small problem with your coverage

New or Renewing Coverage – 60 minutes

Best for:

• Applying for a new health insurance plan
• Renewing your current plan
• Reporting complex changes (like income or household changes)
• Getting coverage if you lost insurance

Omnisalud

Best for:

• Enrolling or re-enrolling in OmniSalud (coverage for undocumented residents)
• Questions about your OmniSalud plan

During Open Enrollment, we will offer appointments on Nov. 3 (Monday), Nov. 10 (Monday), Dec. 1 (Monday), Dec. 8 (Monday), Jan 5, 2026 (Monday), and Jan. 13, 2026 (Tuesday). In-person appointments take place at:

St. Vrain Community HUB
515 Coffman St., Longmont, CO 80501

To schedule, call 303-441-4530 or email healthcoverage@bouldercounty.gov.

Please have these items ready:

• Your username and password for:
  • Connect for Health Colorado
  • Colorado PEAK (for Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus))
• Information about your current doctors or providers
• Any letters or notices about your health insurance

Tips:

• Update or reset your account password before your visit.
• Browse plan options on Connect for Health Colorado ahead of time.

Your next steps depend on the type of coverage you enrolled in:

Connect for Health Colorado plans

• You’re not fully enrolled until you pay your first monthly premium.
• If you didn’t pay during your appointment, pay as soon as possible.
• Call your insurance company 7–10 days after paying to confirm they received it and that your coverage is active.
• Within 2–3 weeks, you’ll get a welcome packet and insurance card(s).

Health First Colorado (Medicaid) or CHP+

• Boulder County has up to 45 business days to process your application or renewal.
• You may be asked for more information later.
• To check your status, log in to your PEAK account.
• You can also read the Health First Colorado Member Handbook for details.

OmniSalud plans

• You’ll get a welcome packet and insurance card(s) within 2–3 weeks.
• If you are paying a monthly premium:
• You’re not fully enrolled until you pay.
• If you didn’t pay during your appointment, pay as soon as possible.
• Call your insurance company 7–10 days later to confirm your plan is active.

Still have questions?

Email us at healthcoverage@bouldercounty.gov

You must report certain changes in your household, such as:

• Income changes
• Household size changes (someone moves in or out)
• Pregnancy
• Changes in citizenship or immigration status
• Loss of job-based insurance

When to Report Changes

• Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus) members: within 10 days
• Connect for Health Colorado and OmniSalud customers: within 30 days

Why It Matters

Reporting changes can affect your tax credits or financial help:

• If income goes up or someone leaves your household, you may get less help. If you don’t report the change, you may owe money at tax time.
• If income goes down or someone joins your household, you may qualify for more help or even free or low-cost coverage.

What Happens Next

If your financial help changes, you can:

• Stay in your current plan with the new amount, or
• Choose a new plan (within 60 days)

If you no longer qualify for help, you can:

• Stay in your current plan and pay full price, or
• Pick a new full-price plan (within 60 days), or
• Cancel your plan

If you qualify for Medicaid (Health First Colorado) or CHP+ (Child Health Plan Plus):

• You can enroll in Medicaid or CHP+ and cancel your marketplace plan, or
• Keep your marketplace plan at full price and use Medicaid as secondary coverage

Many people get Premium Tax Credits in advance (called APTC) to lower their monthly health insurance costs.

At tax time, the IRS checks:

• How much APTC was paid for you during the year
• How much you should have received based on your actual income

If you should have received more credit:

• You’ll get the difference in your tax refund, or
• It will lower the amount of tax you owe

If you received too much credit:

• Starting in 2026, you’ll have to pay back the extra amount
• This will either reduce your refund or increase the taxes you owe

When seeking out care, you always want to stay in-network. Marketplace plans do not pay for care from out-of-network providers. Providers can change networks at any time, so always confirm your doctor or clinic is in-network before you go.

There are different places to go for care depending on the situation:

Primary Care Provider (PCP)
This is who you see for everyday health needs. You can schedule one free checkup with your PCP every year.

Mental Health Provider
All health plans include mental health care. Ask your provider for therapy or counseling if needed.

24-Hour Nurse Line
Call this line anytime to explain your symptoms and ask what to do next.

Urgent Care Clinics
Go here for non-emergencies like earaches, sore throats, sprains, minor cuts, burns, or migraines. Urgent care clinics typically cost less than the emergency room.

Emergency Room (ER) or Hospital
Go here for serious or life-threatening emergencies only. Emergency rooms are always open. This is the most expensive option.

Your health insurance covers many services at no cost to you, even if you haven’t met your deductible. These include:

• Annual Wellness Visit and Women’s Wellness Visit
• Over a dozen different health screenings
• Nutrition counseling for adults at risk for chronic disease
• Fall prevention programs for adults 65 and older
• 14 different vaccines (immunizations to prevent sickness)
• Counseling to prevent sexually transmitted infections (STIs)
• Statin medications to prevent heart disease