Your Health Care Rights
Private Insurance Plans Sold in Colorado* can not:
- Consider being gay, lesbian, bisexual, or transgender a pre-existing condition.
- Decide what is medically necessary for you. That is a decision between you and your medical provider.
- Deny transgender Coloradans services that are offered to non-transgender Coloradans.
- Discriminate based on sexual orientation or gender identity.
- Deny or limit coverage based on “pre-existing conditions” like sexual orientation, gender identity, or health conditions (including HIV status).
*If your health plan ID card has a “CO-DOI” designation on it, your plan is subject to Colorado’s insurance laws and rules.
Learn more about the Division of Insurance (DOI) bulletin that prohibits discrimination in Colorado health plans here.
If you think an insurer has unfairly denied your health insurance claim, you must first file follow the appeal process through your insurance provider, after which you may appeal for an impartial external review through the Colorado Division of Insurance. Refer to this Colorado Division of Insurance Bulletin (B-4.49) in your appeal to your insurer if you believe your claim was denied based on sexual orientation or transgender status.
If the insurer denies your claim after your internal appeal, you may file a complaint with Colorado’s Division of Insurance at 303-894-7490, by email at email@example.com, or by filling out an online assistance request form on the DOI’s website.
If you believe you are being discriminated against based on your sexual orientation or transgender status in your employment, in housing, or by an entity that serves the public (including insurance coverage), you can also file a complaint with the Colorado Civil Rights Division.
- The 2017 open enrollment period is November 1, 2016-January 31, 2017.
- Looking for a transgender-inclusive plan? Check out One Colorado’s 2017 Transgender Health Insurance Buyer’s Guide.
- If you have a “life-changing event,” you may qualify for a Special Enrollment Period (SEP). A 60-day period outside the regular open enrollment period when an individual and their family have a right to sign up for health insurance. SEPs can be used to newly enroll in the marketplace,or to switch to a different plan. Learn more to see if you qualify.
- Apply for health coverage through Connect for Health Colorado here: www.connectforhealthco.com.
Medicaid (Health First Colorado):
- For lower-income individuals and families (individuals with monthly incomes under $1,305 and families of four under $2,688), Medicaid has ongoing enrollment. To determine if you qualify, click here.
- Applying for Medicaid as a same-sex couple: Couples who are legally married in Colorado should apply as one household and identify themselves as being married. Apply for Medicaid here: https://www.healthfirstcolorado.com/.
Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you. All free preventive services offered to non-transgender patients also apply to transgender patients. This includes plans available through Connect for Health Colorado, the state’s health insurance marketplace. To find out more about preventative care benefits, click here: https://www.healthcare.gov/coverage/preventive-care-benefits/.