health literacy Archives - Colorado Association of Health Plans

How Legislation Increases Your Health Insurance Premiums

Kevin McFatridge — Wed, 21 Sep 2022 19:41:32 +0000

Your health insurance premium is based on the prices for medical, hospital, and pharmaceutical services. For the fully insured market (individual, small group and large group), federal and state rules govern the benefits that must be covered for every health plan sold in Colorado. When the government mandates new coverages, those benefits have costs that... Read more »

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Ensuring Quality Behavioral Health in Colorado

Kevin McFatridge — Thu, 08 Sep 2022 20:12:46 +0000

Every Coloradan deserves affordable, comprehensive coverage that provides them with convenient and safe access to care to effectively address physical, mental, and social well-being. To achieve this goal, health insurers are leading the way, pioneering innovative programs to improve the behavioral health of their members. These initiatives include raising patient awareness of the importance of... Read more »

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Ensuring evidence-based, effective treatment for Coloradans

Kevin McFatridge — Fri, 02 Sep 2022 16:21:38 +0000

All Coloradans should receive the most appropriate, effective, and safest medical treatments available. To achieve this goal, prior authorization (PA) is one tool used by health plans and government-sponsored programs including Medicaid, Medicare, and Tricare, to get advance approval of coverage for a medical service or prescription drug.

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Pharmacy Benefit Managers: Helping support carriers to reduce costs to consumers

Kevin McFatridge — Fri, 02 Sep 2022 16:19:45 +0000

Every person deserves access to the medications they need at a price they can afford, especially those who can least afford them. We should not have to choose between innovation and affordability. Pharmacy benefit managers (also known as PBMs) help to bring down the price of medications for consumers by negotiating with providers, hospitals, and... Read more »

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Fiction vs Fact – Medicaid and RAEs

Kevin McFatridge — Fri, 04 Mar 2022 19:03:55 +0000

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Colorado’s Medicaid Program and Behavioral Health

Kevin McFatridge — Tue, 01 Dec 2020 17:03:36 +0000

Every Health First Colorado Member is assigned to a RAE that manages their physical and behavioral health care. Members have access to comprehensive mental health and substance use disorder services through their RAE. There are no-copays for Health First Colorado behavioral health services.

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Mental Health Parity in Medicaid

Kevin McFatridge — Tue, 01 Dec 2020 17:02:00 +0000

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and related federal laws and regulations require State Medicaid agencies to ensure that Medicaid managed care organizations and Medicaid alternative benefit plans provide mental health or substance use disorder benefits that are no more stringent than those imposed upon... Read more »

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Colorado’s Medicaid Program and Physical Health

Kevin McFatridge — Tue, 01 Dec 2020 17:00:04 +0000

Health First, Colorado’s Medicaid program, is a public health insurance program for eligible Coloradans funded jointly by a federal-state partnership. In 2018, Health First Colorado launched the development of the Regional Accountable Entities (RAEs) to help administer Medicaid. The RAE contracts were awarded through a competitive bidding process by the Department of Health Care Policy... Read more »

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The Affordable Care Act Helps Coloradans

Kevin McFatridge — Mon, 26 Oct 2020 20:46:13 +0000

The Affordable Care Act, also known as the “ACA,” the “Patient Protection and Affordable Care Act” or “Obamacare,” reformed the health insurance system in the United States. The goal of the ACA was to get more people insured and more than 20 million people nationally are insured because of the ACA. In Colorado, the uninsured... Read more »

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Health Literacy: Rate Filings 101

Kevin McFatridge — Mon, 30 Dec 2019 21:46:59 +0000

Health insurance carriers must submit all rate changes to the Colorado Department of Insurance (DOI) for review and approval before the rates can be applied to consumers. In the spring, insurance carriers file proposals with the DOI to offer health insurance plans in different regions of the sate on the individual and small group markets... Read more »

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