Individual Marketplace Insurance Changes – Impacting UCHealth Coverage

This is an important reminder that we are currently in the Open Enrollment period for health insurance plans under the federal Affordable Care Act (ACA). Open enrollment for Colorado state-based health insurance ends on December 15, 2020 for coverage starting January 1, 2021.

IMPORTANT UPDATE FOR PATIENTS WITH INDIVIDUAL MARKETPLACE INSURANCE PLANS:

Unfortunately, major insurance companies have very recently made changes to their provider networks for plans purchased on the individual marketplace. Anthem Pathway Network insurance had been the only insurance plan in 2020 that had covered UCHealth in the individual marketplace for patients living in the Denver metro area. Anthem Pathway Network will no longer cover UCHealth providers. This means that for patients living in the Denver metro area, there are no longer any insurance plans offered on the Colorado health exchange marketplace that cover UCHealth providers, including our neurologists. 

Note: These changes do not impact employer-based plans.

If you are currently enrolled in the Anthem Pathway Network Plan (NOT employer-based plan), live in the Denver Metro area, and see one of the neurologists at UCHealth, we advise you to take the following steps to request an extension of your coverage and continuity of care with your UCHealth neurologist:

  1. Call Anthem at the number on the back of your insurance card to initiate the request for continuity of care.
  2. Fill out this template letter (click to download) and complete this form (click to download) to the best of your ability with your information including your current medical treatment needs.
  3. Mail your letter right away to:
    Anthem Blue Cross and Blue Shield
    Attn: HS0535
    700 Broadway St
    Denver, CO 80273
  4. Then, reach out to your Doctor/APP right away and let them know you have sent in your request for continuity of care. Anthem’s medical team will be contacting them to verify that it’s very important for you to receive the 6 month extension for continuity of care. Using My Health Connection is easiest way to communicate this with your care team.

In addition to completing this request for extension of coverage, it is also important to review additional plans and MS specialists for neurologists outside of UCHealth in order to have a back-up plan and your options determined prior to the December 15th open enrollment end date. Other MS Specialist neurologists include Dr. Susan Anzalone, Dr. Siamac Esfandi, Dr. Bev Gilder, Dr. Brooke Allen, and Dr. Sam Cohn.

To look at other plans and providers covered, you can visit Connect For Health Colorado for more information about open enrollment and click here to access Connect For Health Colorado’s plan finder tool directly; Residents of other states should visit HealthCare.gov to get started.  You can also call Connect for Health Colorado to discuss your options directly with an insurance broker or assistant at 855-752-6749.

For more information about UCHealth insurance plans accepted, visit: https://www.uchealth.org/billing-and-pricing/insured-patients/