Frequently Asked Questions
A: Colorado HealthOP is a new alternative to traditional health insurance in Colorado. It is a nonprofit health insurance cooperative that allows you and your family to be part of a community working together toward better health.
A: In a cooperative, the health insurance plan is governed by its members. Members sit on the CO-OP’s board of directors and have a voice in the CO-OP’s operations, including what is covered under benefit plans.
A: Colorado HealthOP is a nonprofit, member-driven health insurance co-op that puts people ahead of profits. We help our members stay healthy by rewarding them for taking healthy actions, because healthier members mean lower healthcare costs for everyone.
A: You must be a Colorado resident to buy insurance with Colorado HealthOP; however, we welcome you to connect with us on our website to keep up to date on changes in healthcare or tips on health and wellness.
A: Colorado HealthOP offers a choice of plans with different provider networks, including plans with statewide networks that are competitive with other major insurers. The switch to Colorado HealthOP’s PPO plans should be no different than a switch to any other insurer. Colorado HealthOP also has plans with more limited, high-quality networks that you can purchase at a lower cost. These plans may be a good choice if you prefer a lower cost over a larger network.
A: Starting January 1, 2014, most Americans will be required to have health insurance. All Coloradans will have the opportunity to get health insurance by purchasing plans on Connect for Health Colorado, Colorado’s online health insurance marketplace. Sign up to receive updates from Colorado HealthOP and we will keep you informed.
A: Income-based federal tax credits are available for some families and individuals via Connect for Health Colorado, the state’s health insurance marketplace.
A: Connect with us to stay informed and Colorado HealthOP will help you learn about the best health insurance options for you. We’ll also help you make healthy decisions today so you can benefit from lower costs and a healthier you in the future.
A: Utilization management (UM) or Utilization Review (UR) means a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, health care services, procedures, or settings. Techniques include ambulatory review, prospective review, second opinion, certification, concurrent review, case management, discharge planning, or retrospective review. For the purposes of this regulation, utilization review shall also include reviews for the purpose of determining coverage based on whether or not a procedure or treatment is considered experimental or investigational in a given circumstance, and reviews of a covered person's medical circumstances when necessary to determine if an exclusion applies in a given situation.