If you have a managed care plan 鈥揾ealth maintenance organization (HMO) or preferred provider organization (PPO) plan, you are required to go to certain doctors and hospitals, and all requests must be reviewed. You have to be covered for emergency services even if the services fall outside of your health plan. And, if you need specialized services, you have the right to be referred to a specialist.
If you are a small employer, no employee can be denied health benefits because of a medical condition, and your policy cannot be cancelled unless you fail to pay the premiums. Your rates cannot be raised if your medical expenses are high, and you can by coverage through one of Colorado鈥檚 health care coverage cooperatives. This allows you to select plans for a variety of insurers. A group health plan might have a 6-month waiting period for pre-existing conditions, but pregnancy is not considered pre-existing and must be covered.
If you are not insured at work and can鈥檛 get individual health coverage because you鈥檝e been turned, you may be eligible for CoverColorado, a subsidized state program for uninsurable individuals. Because of risk factors, CoverColorado premiums are about 30 percent more.
Colorado has several programs for those who cannot afford private health insurance. They include Medicaid, Child Health Plan Plus and Colorado Indigent Care -- a state program that provides partial reimbursement to providers for some of the care.
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