Benefits for Young People
- The Basics
- Why Benefits Matter
- Key Programs
- SSI Eligibility for Young People
- Medicaid and CHP+ Eligibility
- Medicaid Adult Buy-In Eligibility
- Private Health Coverage for Young People
- Other Programs
- Next Steps
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Private Health Coverage for Young People
To get private coverage, somebody — you, your employer, your parents, your parents’ employer — must pay for that coverage. This section introduces the basic ways you can get private health coverage and points out some of the health expenses you may encounter.
Coverage Through Work
Many, but not all, jobs offer health benefits. That’s why private health insurance through work is the most common way that Americans get their health coverage.
If you get your health coverage through your job, usually your employer pays hundreds of dollars each month for it. Depending on your job, you may also have to pay some money each month to keep coverage. The total monthly expense paid for the private health coverage is called the premium.
In addition to the premium you and your employer pay, you have to pay various other expenses out of your own pocket. The most common expenses are called copayments. A copayment means that every time you have a doctor’s appointment, have a test done, or get a prescription filled, you have to pay some money. With private coverage, copayments generally range from about $10 to $50.
Depending on your health plan, you may not have to pay anything for certain services, such as routine testing and vaccinations, but have to pay a lot for other services. Some plans, for example, may require you to pay for half of all your hospitalization expenses, which can add up to hundreds or even thousands of dollars each day. Other plans simply don't cover certain medical expenses, such as wheelchairs or other durable medical equipment.
All plans have an annual limit on the total amount you have to pay in addition to your monthly premium. This limit is called the out-of-pocket maximum. So, if you have a plan with a $2,000 out-of-pocket maximum, once you’ve paid a total of $2,000 in copayments and other medical expenses, you won’t have to pay any copayments or other expenses for the rest of the year. Note: The monthly premium isn't included in this maximum and will still have to be paid.
Coverage Through Parents
Federal law says that parents who get health coverage through their jobs are allowed to add any children under the age of 26 to their plans. Usually, a parent adding a child to their employer-based coverage has to pay some or all of the child's monthly premium.
All private health coverage plans, no matter who pays for them, must cover the Essential Health Benefits (EHBs). This means that they offer comprehensive coverage, including regular checkups, vaccinations, chronic disease management, rehabilitative and habilitative services and devices, and mental health and substance abuse coverage, among other things.
Buying Individual Coverage
Some people pay a health coverage company directly instead of getting it through their jobs or parents. This is called individual coverage. As with employer-sponsored coverage, individual coverage requires you to pay a monthly premium, copayments, and perhaps a deductible, depending on your plan.
Connect for Health Colorado is the easiest place to sign up for individual coverage. It used to be that health insurance companies could deny you coverage or charge you more if you had a disability, but that's not true anymore. Now, anybody can get private insurance.
You should only think about getting an individual plan through Connect for Health Colorado if you cannot get health coverage from:
- Your job
- Your parent’s job
- Your spouse’s job
- Health First Colorado (Medicaid), or
- Medicare.
If you cannot get health coverage from any of the above options, the government may help you pay your monthly premium via a tax credit. If your family’s income is at or below 250% of the Federal Poverty Guidelines (FPG), ($32,200 for an individual or $66,250 for a family of four), the government also helps you get a silver plan that has lower copayments and other expenses.
Note: For 2021 and 2022, there is no income limit for getting subsidies that help pay individual coverage premiums. (The limit used to be 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.

Your family size: | |
Income limits for your family: | |
$13,590 | |
$4,720 | |
$12,880 | |
$4,540 | |
Income-based Health First CO (Medicaid), adults (138% FPG) | |
Child Health Plan Plus (CHP+) (260% FPG) | |
Subsidized private plans, reduced fees (250% FPG) | |
Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
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Read more about how to sign up for individual coverage in DB101's How Health Benefits Work article.
Learn more
Finding the Right Job for You
Get some tips and resources that make it easier to find a job or career.
ABLE Accounts
ABLE accounts help people with disabilities save money without losing benefits.
What Benefits Do I Get?
How to see which Social Security and state benefits you get.
Get Expert Help
SSI and SSDI
How Work Affects SSI and SSDI
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Call Ability Connection Colorado (ACCO)
1-303-691-9339 - Contact a certified benefits counselor
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Call the Ticket to Work Help Line
1-866-968-7842
Health First Colorado (Medicaid)
- Contact your county human services department
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Call Health First Colorado (Medicaid)
1-800-221-3943 -
Call a Medicaid Adult Buy-In expert
1-800-711-6994
Medicare
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Call Medicare
1-800-633-4227 -
Call the Colorado State Health Insurance Assistance Program (SHIP)
1-888-696-7213
Work Preparation
- Contact your Division of Vocational Rehabilitation (DVR) office
- Contact your local Workforce Center
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Call the Colorado Office of Employment First
1-303-318-8574
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