The Colorado Division of Insurance, part of the Department of Regulatory Agencies, is alerting Colorado consumers about the risks of health care sharing programs.
Such programs may mimic the look of Affordable Care Act health insurance – yet they do not offer the benefits of health insurance and do not meet the standards of the ACA.
The DOI urges Colorado consumers to be aware of these conditions on programs:
They do not comply with the ACA. Any advertising or statements by a sharing program saying that it is ACA-compliant should be reported to the DOI.Many sharing programs say they do not guarantee payment for any health care, and the member is ultimately responsible for anything the program does not pay. They typically have restrictions or exclusions on pre-existing conditions.Often they do not provide mental health coverage or substance-use disorder treatment.Members may also be subject to religious or moral restrictions.Health care providers are under no obligation to accept or honor discounts from these programs if there is no contract or agreement to do so.Such programs are set up to avoid insurance regulation and do not offer the consumer protections built into insurance, leaving people limited recourse for complaints or appeals.
For more information, call the DOI at (303) 894-7490 or (800) 930-3745, email DORA_insurance@state.co.us or visit www.AskDORA.colorado.gov and click the “health insurance” tab.
