Can I get HMO Colorado plans in La Plata County?

Yes, HMO Colorado is one of 6 carriers offering marketplace health plans in La Plata County for the 2026 plan year. You can explore their HMO, EPO, and PPO options through Connect for Health Colorado.

What types of health plans are available in La Plata County?

Residents of La Plata County can choose from HMO, EPO, and PPO health plans on the Connect for Health Colorado marketplace. Unlike some states, PPO plans are widely available in Colorado's marketplace.

What is the income limit for Medicaid in Colorado?

Colorado's Medicaid program, Health First Colorado, is expanded. Adults with household incomes up to 138% of the Federal Poverty Level (FPL) typically qualify for coverage with little to no cost. For pregnant women, the income limit is 195% FPL, and for children, it's 260% FPL through CHP+.

How many health insurance carriers offer plans in La Plata County?

For the 2026 plan year, 6 health insurance carriers offer marketplace plans in La Plata County, which is part of Colorado Rating Area 8. These carriers include HMO Colorado, Cigna, Denver Health Medical Plan, Kaiser Permanente, Select Health, and United Healthcare.

Updated July 2026 · ColoradoPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

HMO Colorado Health Insurance Options in La Plata County, CO

HMO Colorado is one of 6 carriers offering marketplace plans in La Plata County for 2026.
La Plata County is part of Colorado Rating Area 8, which includes 12 other counties.
Colorado's Medicaid program, Health First Colorado, covers adults up to 138% of the Federal Poverty Level (FPL).
The average median income in La Plata County is $86,056 per U.S. Census Bureau ACS 2024 5-year estimates.

Navigating health insurance options in La Plata County, Colorado, for 2026 involves understanding the plans available through Connect for Health Colorado, the state's official marketplace. Residents have access to a variety of plan structures, including Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). HMO Colorado is a key provider in this region, offering plans that emphasize coordinated care through a primary care physician. Whether you're seeking individual coverage, family plans, or exploring options with financial assistance, La Plata County offers a robust selection. This guide will help you understand your choices, including specific carriers like HMO Colorado, eligibility for subsidies, and local healthcare resources.

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Understanding Health Insurance Options in La Plata County

La Plata County, with a population of 56,331 and a median income of $86,056 per U.S. Census Bureau ACS 2024 5-year estimates, offers a diverse health insurance landscape. The county is part of Colorado Rating Area 8, which covers Archuleta, Dolores, Gunnison, Hinsdale, La Plata, Mineral, Montezuma, Montrose, Ouray, Rio Grande, Saguache, San Juan, San Miguel counties. This means plan availability and pricing are consistent across these 13 counties. Through Connect for Health Colorado, individuals and families can compare plans, apply for subsidies, and enroll in coverage. Notably, Colorado's marketplace offers a broader choice than some other states, with PPO plans readily available alongside HMOs and EPOs.

ACA Plan Tiers and Subsidies

Health plans on Connect for Health Colorado are categorized into metal tiers: Bronze, Silver, Gold, and Platinum. These tiers reflect the percentage of healthcare costs the plan is expected to cover versus your out-of-pocket expenses.

Bronze plans: Cover about 60% of costs, with you paying 40%. They have the lowest premiums but highest deductibles and out-of-pocket limits.
Silver plans: Cover about 70% of costs, with you paying 30%. These are the only plans eligible for Cost-Sharing Reductions (CSRs), which lower deductibles, copayments, and out-of-pocket maximums for eligible individuals.
Gold plans: Cover about 80% of costs, with you paying 20%. They have higher premiums but lower deductibles and out-of-pocket limits.
Platinum plans: Cover about 90% of costs, with you paying 10%. They have the highest premiums but the lowest out-of-pocket costs.

Many La Plata County residents may qualify for Advance Premium Tax Credits (APTCs) to lower their monthly premiums. Eligibility is based on household income relative to the Federal Poverty Level (FPL). For 2026, enhanced subsidies remain available, making coverage more affordable for a wider range of incomes. You can apply for these subsidies directly through Connect for Health Colorado.

Who Qualifies for Health First Colorado (Medicaid) in La Plata County?

Colorado expanded its Medicaid program, known as Health First Colorado, in 2014. This expansion significantly broadens eligibility, ensuring that more residents of La Plata County can access low-cost or free healthcare.

Adults: Individuals and families with household incomes up to 138% of the Federal Poverty Level (FPL) are generally eligible for Health First Colorado. This means that if your income falls within this range, you may qualify for comprehensive health coverage with minimal or no premiums and out-of-pocket costs.
Pregnant Women: Colorado's Child Health Plan Plus (CHP+) covers pregnant women with incomes up to 195% FPL. This program provides comprehensive prenatal, delivery, and postpartum care. Women at or below 138% FPL will first qualify for full Health First Colorado Medicaid.
Children: CHP+ also covers children in households with incomes up to 260% FPL.

Unlike states that have not expanded Medicaid, Colorado residents earning 100-138% FPL do not face a "coverage gap" and are instead eligible for Health First Colorado. Applications can be submitted through Colorado PEAK (colorado.gov/PEAK).

Health Insurance Carriers in La Plata County

For the 2026 plan year, residents of La Plata County have a choice of 6 health insurance carriers offering marketplace plans in Rating Area 8. This ensures competitive options for finding a plan that fits your needs and budget. The confirmed carriers available in La Plata County include:

Cigna
Denver Health Medical Plan
HMO Colorado
Kaiser Permanente
Select Health
United Healthcare

HMO Colorado, as its name suggests, primarily offers Health Maintenance Organization (HMO) plans, which typically require you to choose a primary care physician within their network and get referrals for specialists. However, they, along with other carriers, may also offer EPO and PPO options in the region. When comparing plans, consider the network of doctors and hospitals, the specific benefits, and the overall cost structure (premiums, deductibles, copayments).

Hospitals and Healthcare Facilities in La Plata County

Access to quality local healthcare is a crucial factor when choosing a health plan. La Plata County is served by two acute care hospitals, ensuring residents have access to necessary medical services. These facilities play a vital role in the community's health infrastructure. The primary hospitals in La Plata County are:

Mercy Regional Medical Center (Durango)
Animas Surgical Hospital, LLC (Durango)

When selecting a health insurance plan, particularly an HMO or EPO, it is essential to verify that your preferred doctors and these local hospitals are included in the plan's network. PPO plans typically offer more flexibility but may still have cost advantages for in-network providers.

Choosing the Right Health Plan in La Plata County

Deciding on the best health insurance plan in La Plata County depends on your individual health needs, financial situation, and preferred access to care. Here's a guide to help you make an informed decision:

Assess Your Income: If your household income is below 138% FPL, apply for Health First Colorado. If it's above this but still qualifies for subsidies, connect with Connect for Health Colorado to see how much you can save on premiums and out-of-pocket costs. Individuals between 150-250% FPL often benefit most from enhanced Silver plans due to Cost-Sharing Reductions.
Consider Your Healthcare Needs: If you have chronic conditions or anticipate frequent medical care, a Gold or Platinum plan with lower deductibles might be more cost-effective despite higher premiums. If you're generally healthy and primarily want coverage for emergencies, a Bronze plan might suffice.
Understand Plan Types:
- HMO: Typically lower premiums, require a Primary Care Provider (PCP) and referrals for specialists. Good if you prefer coordinated care.
- EPO: Similar to HMOs but may not require a PCP or referrals, though you must stay within the network.
- PPO: Offer the most flexibility, allowing you to see out-of-network providers (at a higher cost) without referrals. Generally have higher premiums.
Check Provider Networks: Ensure your preferred doctors, specialists, and local hospitals like Mercy Regional Medical Center and Animas Surgical Hospital, LLC are in the network of any plan you consider.

A licensed health insurance producer can provide personalized guidance, helping you compare plans from carriers like HMO Colorado, Cigna, and Kaiser Permanente, understand your subsidy eligibility, and enroll in the best plan for your circumstances, all at no cost to you.

Frequently Asked Questions

What is Connect for Health Colorado?

Connect for Health Colorado is the state's official health insurance marketplace. It's where individuals, families, and small businesses can shop for health insurance plans, compare options, and determine if they qualify for financial assistance like premium tax credits or cost-sharing reductions.

Are PPO plans available on the marketplace in La Plata County?

Yes, PPO plans are available on the Connect for Health Colorado marketplace in La Plata County. Colorado is one of the states where marketplace shoppers can choose from HMO, EPO, and PPO plan structures, including options from carriers like Denver Health Medical Plan and HMO Colorado.

What is the uninsured rate in La Plata County?

According to U.S. Census Bureau ACS 2024 5-year estimates, the uninsured rate in La Plata County is 8.2%. This figure indicates the percentage of the population without health insurance coverage.

Does pregnancy qualify as a special enrollment period in Colorado?

No, pregnancy alone is not considered a qualifying life event for a Special Enrollment Period (SEP) under the Affordable Care Act (ACA). However, the birth of a child is a qualifying life event that allows you to enroll in or change your health plan. Additionally, pregnant women in Colorado may qualify for Health First Colorado or CHP+ based on income.