Dually Insured in Colorado – What You Need to Know

By Carol Meredith, Executive Director

Carol Meredith

Here at The Arc, we hear that a lot of misinformation is being shared with families and people with disabilities about how the system works.  This update is an attempt to ensure that everyone has the facts.

Recently it has come to our attention that individuals and families are being asked to pay co-pays and deductibles for medical care when they are dually insured.  Dually insured means that the person is enrolled in a private/commercial health insurance plan and also has Medicaid (Health First CO).  If you or your son or daughter is dually insured, it is illegal for any medical provider to bill that person.  Please note: sometimes adults on Medicaid are charged a very small co-pay for prescriptions or doctor’s visits, but these co-pays are typically under $5.00.

If this has happened to you, you can contact Medicaid Provider Services at 1-844-235-2387 and request a “NOTICE TO COLORADO MEDICAID PROVIDER OF UNAUTHORIZED BILLING ACTION” letter.  The document states, “no client shall be liable for the cost, or the cost remaining after payment, by Medicaid, Medicare or private insurer of medical benefits authorized under Title XIX of the Social Security Act.”

A few of the people we work with have already received refunds for being billed mistakenly.  Good to know!

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