HB 18-1370

HB 18-1370, also known as the Drug Coverage Health Plan bill, aims to protect patients by ensuring that if a drug was covered when they enrolled in their health insurance plan, it cannot be excluded or moved to a less favorable tier later on. This means that once a drug is covered for you, your insurer can't suddenly make it harder or more expensive for you to get it. The bill also allows insurers to offer cheaper generic alternatives if available and the patient agrees. Since this bill has been signed into law, health insurance carriers in Colorado must now follow these rules, protecting patients from unexpected changes in their drug coverage.

Official Summary

The bill prohibits a health insurance carrier from excluding or limiting a drug under a health benefit plan and from moving the drug to a disadvantaged tier in the plan formulary if the drug was covered at the time the covered person enrolled in the plan. A carrier may not increase the amount that a covered person pays for a copayment, coinsurance, or deductible or set limits while the covered person is covered by the health benefit plan for drugs that were covered when the person became covered under the plan. If a carrier uses a tiered plan, the carrier may not move a drug to a disadvantaged tier under specified circumstances. A carrier may limit coverage for a drug or biosimilar product if a provider prescribes a generic drug or biosimilar product to treat the covered person's medical condition instead of the originally-prescribed drug and the covered person agrees. (Note: This summary applies to this bill as introduced.) , Read More