Having Issues With Your Health Care?
Do you have any questions or issues with your current health care coverage?
CCHI has created guides and information below to provide consumers with the best contacts and resources to help them resolve their issue.
Issues with Private Health Insurance
If you’re running into problems with your insurance and coverage under your plan, you should first directly contact your health insurance company to attemp to resolve the issue. If the issue is not resolved, contact Colorado’s Department of Insurance (DOI). They can answer questions about your health insurer, policy, billing practices, and your rights and protections.
If you are encountering a surprise medical bill,
What you can do:
Issues with a Marketplace Plan (Connect for Health Colorado)
If you are having issues with enrollment through Connect for Health Colorado, their service center, health coverage guides, advance premium tax credits, or paying your premiums, contact Connect for Health Colorado.
What you can do:
Issues with Medicaid/CHP+ Coverage
If you are having issues with your membership or benefits, or finding providers or services, contact Colorado’s Department of Health Care Policy and Financing (HCPF).
What you can do:
- Call the Medicaid Customer Contact Center at toll-free at 1-800-221-3943
- Report Suspected Medicaid Fraud
Issues with Hospital Financial Assistance/Charity Care
If you are having issues with hospital bills visit our Hospital Financial Assistance page.
Prescription Drug Costs
Drug costs are disproportionately higher in the U.S. than in other countries, and they are continuing to rise.
Pharmaceutical companies have monopolized our prescription drug market. Among other systemic drivers, patents and exclusive marketing rights granted by the FDA block lower cost generic drugs from entering the market and lead to price inflation.
These high costs are a substantial barrier for many. Fortunately, CCHI’s Consumer Assistance Program has a tool, VIVOR, that can help you get more affordable prescriptions.
After we build your unique profile, VIVOR matches you with underused, money-saving resources.
There are two main types of assistance offered through VIVOR: manufacturer assistance and foundation assistance.
Manufacturer assistance is help available directly from the company that makes your medication. For these programs, you must be commercially insured, but there are typically no income guidelines. You could get help with the copay, coinsurance, or deductible costs for your prescription drugs. Some manufacturers even offer support for the out-of-pocket costs of infused drugs.
Foundation funding is offered by nonprofit organizations. Because these organizations rely on donations, the availability of funding can be unpredictable. CCHI receives regular updates on the opening and closing of funds. In order to be eligible for help, you must meet income guidelines based on the Federal Poverty Level (FPL) and have immediate financial need. The grants can cover the out-pocket cots of your medication, insurance premiums, or travel costs and other treatment-related expenses.
For both of these assistance options, benefits and eligibility vary for each program.
VIVOR can also match you with patient assistance programs (PAPs) that offer free or replacement medication. Typically these programs are intended to support uninsured people and those whose health plan does not cover a particular brand-name drug. You may also qualify if you are on Medicare but no foundation funding is available for your diagnosis. Depending on your condition, the free medication or replacement products can be shipped to the infusion center, doctor’s office, or directly to your home.
If you are struggling with the high cost of prescription drugs, we encourage you to reach out to us and set up a VIVOR profile. In many cases, prescription drugs lead to a better overall health outcome and even lower overall health care costs.
For example, one of our clients asked us for help with lowering the cost of her Tymlos and Trulicity medications. Without insurance, Tymlos can cost $1800 or more per injection pen, and each pen only contains 30 doses. The client’s Medicare Part D covered some costs, but she was still paying $500 per month for Tymlos alone. Trulicity lists at $800 per month, which added to her financial strain.
Fortunately, she qualified for manufacturer assistance programs in VIVOR for both medications. Through Together with Tymlos and Lilly Cares Foundation, our client gets her medications for free. She saves $1300 each month.
If you need help with prescription drug costs, contact our Consumer Assistance Program
Want more information on how we are combating high drug costs? Email our Policy Manager, Isabel Cruz, at firstname.lastname@example.org to get involved and subscribe to our updates. If you have a story about how high drug costs has impacted your life or your loved ones that you would like to share, share your story or reach out to chat with us. We are always looking for advocates and leaders like you to join our efforts and help us advance health equity–we’d love to hear from you!
How can we help?*
Applying for financial assistance for a hospital procedure
Screening for health coverage through Medicaid
Appealing a health insurance medical claim denial
Screening for prescription drug cost assistance
*Note: CAP services include medical bill and claim navigation, but we do not offer financial help to pay for medical bills or prescriptions.