Carelon

Health Insurance Coverage in Colorado

Health Plan Overview

Insurance Company	Carelon
State	Colorado
Website	carelon.com
Number of Hospitals in Network	4
Number of Plans Offered	8

Network Hospital Locations

Hospitals in Network (4)

Children's Hospital ColoradoChildren's Hospital Colorado, Colorado SpringsPeak View Behavioral HealthJohnstown Heights Behavioral Health

Available Plans

Employer Group Plan

1 plan

Government Program

1 plan

Health Plan

5 plans

Pharmacy Benefit Management

1 plan

Plan Details

Plan Name	Plan Type
NA	Health Plan
NA	Health Plan
NA	Health Plan
NA	Health Plan
NA	Employer Group Plan
NA	Pharmacy Benefit Management
NA	Health Plan
NA	Government Program

Recent News

2025-04-30

Updates to the Carelon Medical Benefits Management Clinical Appropriateness Guidelines will be effective for dates of service on and after August 1, 2025. These updates include changes to guidelines for genetic testing, such as chromosomal microarray analysis and optical genome mapping.

2025-04-01

Effective April 1, 2025, Carelon Behavioral Health will no longer accept new Medicaid provider applications for Northeast Health Partners or Health Colorado, Inc. Existing in-network providers with these entities who wish to add practitioners can continue the enrollment process.

2025-02-04

Effective March 1, 2025, Carelon Medical Benefits Management began conducting clinical appropriateness reviews of cardiovascular, musculoskeletal, and surgical procedures for Anthem Blue Cross and Blue Shield and HMO Colorado members. Prior authorization requests were accepted starting February 24, 2025.

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