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Division of Insurance warns Coloradans about the limitations of health care sharing

By David Mullen December 11, 2020 | updated 5 years ago

The Colorado Division of Insurance is warning consumers about the risk of Health Care Sharing Programs or ministries as open enrollment continues through Jan. 15.

Officials say these programs or ministries look complete on the surface, but often do not offer the same benefits or protections as plans such as the Affordable Care Act.

“I’m worried that many people will only find out about what these programs don’t cover when it’s too late — when they’re already at the hospital or when they get a large bill in the mail,” said Colorado Insurance Commissioner Michael Conway.

“Up front, these programs look like they can save you money, but the costs to a consumer on the back end will not only be surprising, but also a serious financial blow. People need to understand the limitations of these products, especially in the midst of (a) pandemic.”

Anyone hoping to have coverage through the ACA is required to be enrolled by Dec. 15 to utilize the services. 

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According to DOI, these plans will claim to have low monthly premiums that encourage people to join, and even mimic traditional insurances by having multiple levels such as bronze, silver and gold tiers. 

However, many times these programs or ministers “don’t pay, leaving the members with the doctor and hospital bill,” the release read.

Officials are encouraging anyone thinking about signing up for these plans to consider the following:

  • These programs typically have restrictions or exclusions on pre-existing conditions, leaving members responsible for the health care costs for those conditions.
  • Members may also be subject to religious or moral restrictions from the sharing ministry, which could leave members responsible for the full costs of health care that results from an activity the ministry does not approve of.
  • Often these programs do not provide mental health coverage or substance use disordering treatment.

All of these factors are against the ACA coverage requirements and anyone being solicited about plan that does not meet the requirements are encouraged to report this to DOI’s consumer service team at 303-894-7490 or 1800-930-3745 for those outside of the Denver metro.

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View Original Article | Split View
David Mullen

Reporter

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