Medical
Denver Health offers three medical plan options through the Denver Health Medical Plan.
Before you enroll in medical coverage, take some time to fully understand how each plan works.
ASK YOURSELF THESE QUESTIONS:
- Do you live in the Denver area and plan to use the Denver Health network and services?
Consider the Medical Care HMO. You will pay less from your paycheck each pay period for coverage and have access to services in the Denver Health network. - Do you live outside of the Denver area?
Consider the HighPoint HMO or HighPoint POS plan. You will have a wider selection of providers outside of the Denver Health network and be able to seek care closer to you at UC Health or Intermountain Health. - Can you set aside money from your paycheck to help pay for out-of-pocket expenses?
Consider funding a flexible spending account (FSA). All three plans allow you to fund a health care and/or dependent care FSA to pay for eligible expenses with tax-free dollars.
MEDICAL COSTS
Listed below are the biweekly costs (24 pay periods) for medical insurance. The amount you pay for coverage is deducted from your paycheck on a pre-tax basis, which means you don’t pay taxes on the amount you pay for coverage.
Full-time benefits eligible: 0.75 to 1.0 FTE
Part-time benefits eligible: 0.50 to 0.74 FTE
The Denver Health Medical Plan offers in-network benefits only.
Denver Health provides you with three different medical plan options with different networks from the Denver Health Medical Plan (DHMP):
- Medical Care HMO: Denver Health main campus and clinics
- HighPoint HMO: Denver Health, University of Colorado, Intermountain Health (formerly SCL) (Denver-area locations) and Children’s Hospital and affiliated network providers
- HighPoint POS: Denver Health, University of Colorado, Intermountain Health (formerly SCL) (Denver area locations), Children’s Hospital, plus First Health network facilities and providers
Locate a Denver Health network provider at goperspecta.com/VPD/dhmp/public/ProviderSearch/SelectProduct > Select the dropdown menu > DHHA > Choose your medical plan.
The table below summarizes the benefits of each medical plan. The coinsurance amounts listed reflect the amount you pay. Please refer to the official plan documents for additional information on coverage and exclusions.
(1) Prices listed are for Denver Health Pharmacy. Please note if you fill your prescription at a national network pharmacy the price may be up to 2x the listed copays above. All medications are not available to fill outside of Denver Health. (2) Specialty medication is not eligible for mail order.
Note: Prior authorization may be required for some services. Please refer to the prior authorization list or call 303-602-2100 (toll free: 800-700-8140; TTY/TTD users: 711) Monday-Friday, 8 a.m. to 5 p.m. MST with questions.
ARE YOU COVERING YOUR SPOUSE, PARTNER AND/OR DEPENDENT CHILDREN?
In an embedded deductible plan, cost sharing for a member will begin when that member reaches their individual deductible or when a combination of members reaches the family deductible. This means that a member will start to pay copays and/or coinsurance for the remainder of the plan year or until the individual out-of-pocket maximum is met. Once the individual reaches their out-of-pocket maximum, then the plan will pay 100% of covered services for that member for the remainder of the plan year.
Note: An individual who meets their individual deductible will initiate cost sharing with the plan prior to other members on the plan.
OUT-OF-AREA EMPLOYEES AND DEPENDENTS
Out-of-area employees and dependents may qualify to access the national First Health network. For more info visit Out-of-Area/Out-of-State Spouse or Dependents | Denver Health Medical Plan.
PREVENTIVE CARE
In-network preventive care is 100% free for medical plan members.
You won’t have to pay anything out of your pocket when you receive in-network preventive care. Practice preventive care and reap the rewards of a healthier future.
Some services are generally not considered preventive if you get them as part of a visit to diagnose, monitor, or treat an illness or injury. Please be aware that you will be responsible for the cost of any non-preventive care services you receive at your preventive care exam based on your plan design.
Learn more about preventive care at denverhealthmedicalplan.org.
VISION CARE
If you enroll in a Denver Health Medical Plan, you will have access to enhanced vision benefits:
- $30 copay per visit for routine eye exams at either Denver Health Eye Clinic or Eyecare Specialties of Colorado (limited to one routine eye exam every 24 months).
- The date(s) of service for requested reimbursement cannot be within 24 months of your last requested reimbursement date(s) of service.
- $200 toward Lasik surgery once per lifetime.
VIRTUAL MENTAL HEALTH CARE
You have access to virtual mental health care through Elevate Mind. Whether you’re on the go, at home or at the office, care comes to you in the form of virtual mental health care.
- Receive mental health support and counseling.
Hand-selected, U.S.-trained, board-certified licensed therapists and psychologists can help diagnose, treat and even prescribe medication when needed for depression and anxiety, substance abuse and panic disorders, PTSD, grief and loss and more. - Talk with a licensed therapist or psychologist by phone or video, 24/7.
Use virtual mental health care to prioritize your health by getting the care you need when you need it. Visit denverhealthmedicalplan.org, email dhmpmemberservices@dhha.org or call 303-602-2100.
DISPATCHHEALTH
DispatchHealth provides on-demand health care in the convenience of your home. They can treat many of the same illnesses and injuries that are treated at an urgent care center.
Services are only available in certain geographic areas. However, new locations are added all the time. Visit dispatchhealth.com or call 888-908-0553 to see if DispatchHealth is available in your area.
KNOW WHERE TO GO FOR CARE
Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider. Use the chart below to help you choose where to go for care.
OPEN ENROLLMENT FOR 2024 BENEFITS HAS ENDED.
IF YOU ARE A NEW HIRE OR IF YOU HAVE EXPERIENCED A QUALIFYING LIFE EVENT, PLEASE FOLLOW THE INSTRUCTIONS BELOW.
- Contact the Benefits Concierge Center at 303-602-6947, Option 2 (Monday - Friday from 6 a.m. to 6 p.m. MST) during the open enrollment period. Benefits counselors are ready to assist you.
- Book an appointment with a benefits counselor below.
- Self-enroll by logging into the Workday system. If you need assistance with your username and password, please contact the IT help desk at 303-436-3777.