Colorado Health Insurance Laws

At one point or another, everyone finds themselves in a situation that necessitates the use of the American healthcare system. For a lot of us, our lives begin and end in a hospital. In order to protect ourselves financially, we purchase health insurance. Have you ever looked into the laws that govern our health insurance system? Maybe you have, now that ObamaCare is the talk of the nation. Even if you have been researching insurance laws, it’s likely that most people don’t spend their free time reading up on it. It’s unfortunate, but we will all get sick or injured at some point. We end up spending a lot of time and money on healthcare. So doesn’t it seem important to be familiar with the laws that govern health insurance? For your convenience, the following paragraphs contain brief explanations of a few of the most important health insurance laws in Colorado that may be important for you to know.

For the Consumer

Health Insurance Portability and Accountability Act or HIPAA. HIPAA has a lot of different facets. It…

• Limits insurers’ power to deny/delay claims.
• Minimizes your chances of losing your coverage.
• Makes it safer and easier for you to change health plans.
• Prohibits discrimination based on health problems.
• Protects patients’ privacy if they are over 18—other than you and your health care providers, no one can gain access to your health care records unless you have expressly given your consent.

Other health insurance laws for the consumer include…

• Coloradans are guaranteed renewable insurance plans, meaning your insurer can’t cancel your coverage if you get sick or injured.
• Consolidated Omnibus Budget Reconciliation Act or COBRA. COBRA guarantees continuation of group coverage from a former employer for up to 18 months.

For the Insurer

All Colorado insurance plans are required to provide coverage for certain services including:

• Breast and prostate cancer screenings
• Treatment for certain diabetes-related conditions
• Children’s vaccinations

The Affordable Care Act (Obamacare) requires insurers to…

• Allow children to stay on their parents’ insurance until they are 26.
• End the practice of denying coverage based on pre-existing health conditions.
• Publicly justify their actions if they want to raise their rates by more than 10%.
• Discontinue placing lifetime dollar limits on plans.
• Cover preventive services with no deductible or co-pay.
• Spend at least 80 cents of your dollar on health care and improvements to health care—not administrative costs—or give you a refund.

Other health insurance laws for the isurer include…

• Insurers maximums for physical and mental health conditions must be the same.
• Individual insurance plans must include maternity coverage.

These are just a few of the most important health insurance laws in Colorado. If you would like more information on these and other laws visit www.colorado.gov, www.healthcare.gov, and www.hhs.gov. Be informed about the health insurance laws that affect you. Knowing the laws helps you better understand how your health insurance works and what you can expect from your policy. You may also contact us, Rocky Mountain Health Brokers, at either 303-523-7650 or email us here. We’d be glad to answer all your health insurance questions!