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Cost-Sharing Requirements and Limitations

  • Date updated 2020-03-04
  • By Dexter Brooks

What is my cost share for insulin/

Carriers that provide coverage for prescription insulin drugs shall cap the cost-sharing charged to the covered person per prescription to $100 per thirty (30) day supply regardless of the type of insulin drug prescribed and filled in that thirty (30) day period. Carriers shall not charge any additional copayments, deductibles or coinsurance for an additional fill of that same prescription in [...]

Surprise Billing

  • Date updated 2020-03-04
  • By Dexter Brooks

What is surprise billing?

Beginning January 1, 2020, Colorado state law protects you from ”surprise billing”. This is sometimes called “balance billing” and it may happen when you receive covered services, other than ambulance services, from an out-of-network provider in Colorado. This law does not apply to all health plans and may not apply to out-of-network providers located outside of Colorado. [...]

Cobra

  • Date updated 2019-04-07
  • By Dexter Brooks

What is COBRA coverage?

IMPORTANT INFORMATION ABOUT COBRA COVERAGE The following information is an overview of healthcare continuation coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"). It is not intended to be a complete description of COBRA requirements. Each employer plan is unique and may therefore permit some variations from the general rules described here. What is COBRA [...]

How to enroll

  • Date updated 2019-04-07
  • By Dexter Brooks

I need Insurance?

Thanks for contacting HealthNetCO! You may change or apply for health care coverage during an annual open enrollment period. Outside of the open enrollment period, you have a special enrollment period “Triggering Event” to enroll or change your coverage if you experience what’s known as a triggering event. Examples of triggering events include getting married, having a baby, and [...]

What Is a "Gainful" Occupation?

  • Date updated 2019-04-07
  • By Dexter Brooks

What Is a "Gainful" Occupation?

If there's no job you can reasonably do where you make at least 60-80% of your pre-disability earnings, your long-term disability company should pay you benefits. What does it mean to not be able to "engage in a gainful occupation"? Long-term disability (LTD) policies typically define "disability" in one of two ways. In an "own occupation" policy, you're disabled and entitled to long-term [...]

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Author Information

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    Dexter Brooks




    Description:
    Total articles: 88
    Article Categories: 12
    • General Questions
    • Shop
    • Disability Insurance
    • Cobra
    • Special Enrollment
    • Medicaid
    • Short Term Health Plan
    • Health Plans
    • Medicare
    • Surprise Billing
    • Insulin
    • Cost-Sharing
    Article Tags: 7
    • benefits
    • health care
    • care coordination
    • Billing
    • prescriptions
    • health plans
    • hmo

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