Chronic Care Collaborative - Centering and Elevating Voices

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The Chronic Care Collaborative (CCC) represents all people in Colorado living with chronic conditions and their caregivers. We want to meet you where you are as best as we can. Your experiences interacting with healthcare providers, insurance, and systems of care are important in helping us understand what is, and is not, working for you.

All answers are confidential and will be used so the CCC can better learn about specific barriers to care and advocate for policies that improve access and affordability.

Email *

First Name

Last Name

Age

Under 40

40 to 65

65 +

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What is your zip code?

I am answering as:

A person living with a chronic disease.

A caregiver for someone living with a chronic disease.

Health care advocate

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What type of health insurance do you currently have?

Insurance through my employer, or a family member's employer

Small business insurance through Connect for Health Colorado

Individual insurance through Connect for Health Colorado

Coverage through a cost-sharing ministry

Medicare

Medicaid/Health First Colorado

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Please select topic areas in which you have experience personally or as a caregiver. Please select all that apply.

Due to COVID-19, I receive primary care services via tele-health.

Due to COVID-19, I receive specialty care services via tele-health.

Due to COVID-19, I receive behavioral health services via tele-health.

Due to COVID-19, I no longer receive regular or necessary health care services.

Due to COVID-19, I have experienced a change or loss of health insurance.

As a caregiver, I am experiencing new challenges or barriers in supporting someone with a chronic disease.

I have experienced insurance barriers to care, such as prior authorization, step therapy, or loss of coverage for my treatment mid-plan year.

I have accessed a patient assistance program to help cover the cost of my prescription medications.

Where I live, there isn't affordable health insurance options or there is only one insurance carrier.

I am currently using a prescription medication that costs me more than $250 per fill.

Other:

Learning more about first hand experiences with health care challenges helps us better advocate for policy improvements. May we reach out to you directly to learn more about your experience(s)?

Yes

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If yes, what is the best way to contact you?

Submit

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