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The Division of Insurance (DOI) regulates the health insurance industry in Colorado and ensures companies follow state and federal laws. The following resources help explain the rights and protections of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Coloradans when accessing health care and benefits, and provide additional information when working with a medical or behavioral health provider, as well as various community resources.
If you feel you have been discriminated against by a health insurance plan, you can contact the Division to ask a question or file a complaint at 303-894-7490 / 800-930-3745 / DORA_Insurance@state.co.us or visit our "Ask a Question / Make a Complaint" page.
If you feel you’ve been discriminated against within a health care setting, you can file a charge of discrimination with the Colorado Civil Rights Division through their "Filing a Charge of Discrimination" page.
You can also file a federal civil rights complaint with the U.S. Department of Health and Human Services here.
Know Your Health Care Rights
Colorado Regulation 4-2-62 prohibits discrimination in private health insurance plans based on sexual orientation or gender identity. Private insurance plans sold in Colorado* CANNOT:
*If your health plan ID card has “CO-DOI” on it, your plan is regulated by the Colorado Division of Insurance and subject to Colorado’s insurance laws and regulations.
You cannot be denied or charged more for health insurance because of your sexual orientation or gender identity. You also cannot be discriminated against when you receive health care services, from hospitals or other health care providers, based on your sexual orientation, gender identity, or disability (which includes HIV status).
If you feel as though you’ve been discriminated against within a health care setting, you can file a complaint with the Colorado Civil Rights Division.
If you feel as though you’ve been discriminated against with your health insurance, you can contact the Division to ask questions or file a complaint: 303-894-7490 / 800-930-3745 / DORA_Insurance@state.co.us or visit our "Ask a Question / Make a Complaint" page.
Health insurance plans can be divided into two categories: public and private.
Private health insurance
Private health insurance plans are run by commercial insurance companies, and include individual and group health plans. You can purchase an individual health plan directly to provide coverage for yourself and your dependents; group plans are purchased by employers to provide coverage for their employees. Individual health plans and group plans regulated by the Division of Insurance (as indicated by a "CO-DOI" designation on the health plan card) must include the following protections:
Public health insurance (Medicare and Medicaid)
The two main types of public health insurance are Medicaid and Medicare. Colorado's state Medicaid program, called Health First Colorado, is administered by the Colorado Department of Health Care Policy and Financing.
Medicare is run by the U.S. Department of Health and Human Services, and provides health insurance to millions of older and disabled Americans. Medicare provides for transgender healthcare such as routine medically necessary care, hormone replacement therapy and gender reassignment surgeries.
For information on how to enroll in private and public health insurance, see the "Get Covered" section below.
Under all Marketplace plans and most private plans, you have access to free preventive services to help you get the treatment you need. Services include:
Get Covered by Health Insurance
Why should LGBTQ people get covered?
How can Coloradans get coverage, including LGBTQ people?
You can purchase individual or family health insurance coverage through Connect for Health Colorado (the state's marketplace), an insurance broker, or by contacting an insurance company directly. Open enrollment for individual and family health plans in Colorado begins on November 1 and ends on January 15 each year. You must sign up by December 15th for coverage that starts in January of the following year.
If you need insurance outside of the standard enrollment period, you may qualify for a Special Enrollment Period (SEP), depending on your situation. An SEP is a 60-day period outside the regular open enrollment period when an individual and their family have a right to sign up for health insurance due to “a “life-changing event,” and can be used to newly enroll in the marketplace, or to switch to a different plan. Learn more to see if you qualify.
Connect for Health Colorado
Connect for Health Colorado is the state’s marketplace to purchase health insurance. As the official health insurance marketplace for Coloradans, it provides:
Health care navigators are available to help you find plans that contain the coverage you need. In addition, One Colorado provides a variety of resources to help find the insurance carrier that’s right for you, including the following guides.
(Note: the guides listed above were prepared for the 2020 open enrollment period, which closed on Jan 15, 2020. New materials for this year's open enrollment period, which begins on November 1, 2020, will be available later this fall.)
Many Coloradans receive health insurance through their employers. Employers may provide coverage by purchasing a health insurance plan from an insurance company, which is called a "fully insured" plan. All fully-insured group health plans are regulated by the Division (as indicated by a "CO-DOI" designation on the health plan card), and must include the same protections as individual health insurance plans.
In some instances, an employer may create their own health plan, and collect premiums and pay claims directly, instead of purchasing a plan from an insurance company. Such plans, often referred to as "self-funded," are regulated at the Federal level by the U.S. Department of Labor and the Treasury Department, and are still required to comply with certain components of state and federal law. It may be difficult to tell if your employer's plan is self-funded, because many employers will use an insurance company to administer the plan, so you may get information and even your insurance card from that insurance company. Many large private sector employers have taken steps to actively remove exclusions on transgender healthcare from their self-funded plans. The Human Rights Campaign (HRC) Corporate Equality Index surveys employers on this important benefit. HRC also offers a List of Businesses with Transgender-Inclusive Health Insurance Benefits.
Health First Colorado is a public health insurance program for Coloradans who qualify. You may qualify for Health First Colorado if you meet certain income requirements and fall under one of the following categories:
Health First Colorado has ongoing enrollment for lower-income individuals and families (individuals with monthly incomes under $1,305 and families of four under $2,688), To can see if you qualify and to apply for coverage, review the application website for Health First Colorado.
Medicare provides health insurance to older (65 and over) and certain younker people with disabilities. To find out additional information about eligibility and enrollment, you can visit Medicare.gov or call Medicare Customer Service at 1-800-663-4227.
On June 15, 2020, the Supreme Court of the United States (SCOTUS) issued a landmark civil rights decision, ruling that LGBTQ workers are protected under Title VII of the Civil Right Act and cannot be fired solely based on sexual orientation or gender identity. This ruling means that LGBTQ Americans throughout the country cannot be fired from their job, and thus lose access to their employer-based health care, because of who they are. Governor Polis issued a statement in support of the SCOTUS decision, reiterating the administration’s commitment “to lead on anti-discrimination policies… to build a Colorado for All.” LGBTQ Coloradans have been protected from employment-based discrimination since 2008, when the Colorado Anti-Discrimination Act was passed.
The DOI is committed to ensuring LGBTQ Coloradans have equitable access to health insurance coverage and the benefits and services that will allow them to lead healthy and affirmed lives. The Division uses its regulatory authority over health insurance companies to enforce federal and state protections for LGBTQ individuals seeking health care; however, if you feel you have been discriminated against, and/or denied access to benefits, please contact the appropriate state or federal authorities to ask a question or file a complaint.
Federal Rights and Protections
The ACA prohibits the denial of health care coverage for individuals and families based on pre-existing conditions, which include HIV status, having received or receiving gender-affirming care, and a history of chronic illness or disease. While the ACA does not mandate insurance plans offer coverage that is inclusive of all LGBTQ needs, it does prohibit insurance companies from categorically denying coverage for services, such as gender-affirming care or from denying a benefit that is covered for other people.
Section 1557 of the ACA prohibits discrimination against LGBTQ people in health insurance coverage and health care. The federal rule implementing Section 1557, released in 2016, includes explicit protections for LGBTQ individuals on the basis of sex stereotypes and gender identity. The federal rule implementing Section 1557, released in 2016, includes explicit protections for LGBTQ individuals on the basis of sex stereotypes and gender identity. On June 12, 2020, the Trump administration finalized a new federal rule that dramatically alters the protections provided through Section 1557. The new rule eliminates protections for transgender individuals, ends the previous rule’s prohibition against discrimiation based on stereotyping. Additional information about the new rule and its implications for LGTBQ individuals is available here.
It is very important to note that while this federal rule was eliminated, transgender Coloradans are still protected from discrimination in health care because of Colorado's Anti-Disrcrimination Act, as well as other health-specific, state-based protections. Governor Polis issued a statement condemning the federal rule's rollback of civil rights protections in health care, and reiterated Colorado's commitment "to remain vigilant to safteguard the rights and protections we have fought so hard to gain. While the Trump administration wants to take our country backward and discriminate against transgender individuals for health care, Colorado law continues to protect Coloradans from such discrimination."
If you have experienced discrimination on the basis of your sexual orientation or gender identity in a health care setting, you can file a complaint with the U,S. Department of Health and Human Services Office for Civil Rights, Additional details on drafting a complaint, as well as an electronic complaint form, are availalble here.
Colorado Rights and Protections
In 2008, the state of Colorado passed the Colorado Anti-Discrimination Act (CADA) which protects Coloradans from discrimination based on disability, race, creed, color, sex, sexual orientation, marital status, familial status, religion, national origin, or ancestry. These protections apply to education, employment, and in places of public accommodation, such as health care facilities. The state of Colorado defines sexual orientation as “an individual’s orientation toward heterosexuality, homosexuality, bisexuality, or transgender status or another individual’s perception thereof.”
CADA created the Colorado Civil Rights Division. The Director and the staff of the Division receive, investigate, and make determinations on charges alleging unfair or discriminatory practices in violation of the Act. If you feel like you have been discriminated against within a health care setting or wrongfully denied benefits, you can file a a charge of discrimination with the Colorado Civil Rights Division through their "Filing a Charge of Discrimination" page.
If you feel you have been discriminated against by a health insurance plan, you can contact the Division to ask questions or file a complaint: 303-894-7490 / 800-930-3745 / DORA_Insurance@state.co.us or visit our "Ask a Question / Make a Complaint" page.
The DOI is committed to ensuring lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans are able to access health care and live healthy and affirmed lives. Since the passage of the federal Affordable Care Act (ACA) and the state's expansion of Health First Colorado (Medicaid) in 2014, over 600,000 Coloradans have gained insurance, and the rate of uninsured LGBTQ individuals has fallen from 10% to 5% since 2011 (Closing the Gap: The Turning Point for LGBTQ Health, 2019). Yet LGBTQ Coloradans still often face difficulties in achieving a healthy life. In addition to concerns about healthcare affordability, access, and the quality of care, they face several unique challenge that affect their ability to live healthy and affirmed lives. Lack of understanding, discrimination, stigma, violence, and higher rates of health problems are just some of the issues that can compound and result in worse health outcomes.
For more information about the LGBTQ health insurance-related issues, contact Cara Cheevers, Behavioral Health Program Manager for the Division of Insurance - email@example.com.