Denver Health Medical Plan

What Denver Health Medical Plan does

Denver Health Medical Plan, Inc. (DHMP) is a Colorado-incorporated nonprofit health insurance carrier founded in 1997, operating exclusively as a subsidiary-aligned entity to the Denver Health Hospital Authority. The company administers a diversified portfolio of government and commercial health plans — Individual & Family Exchange/Colorado Option plans, Elevate Medicare Advantage (including an HMO D-SNP for dual-eligibles and an HMO Select product), Elevate Child Health Plan Plus (CHP+), Elevate Medicaid Choice (Health First Colorado), and DHHA Employer Plans (an HMO and an Extended POS) — serving more than 100,000 members across roughly 8 Colorado counties anchored in the Denver metropolitan area.

The platform is built on a HealthTrio-connected MyDHMP Member Portal with iOS and Android apps, integrated with the Denver Health MyChart patient portal for scheduling and records, and with the MedImpact pharmacy benefit manager for drug pricing, prior authorization, and Birdi mail-order fulfillment. Telehealth visits are delivered through the Denver Health network, with non-emergency medical transportation provided through MTM (Uber/Lyft-integrated) and in-home urgent care via DispatchHealth. Care management digital tools (Wellframe, myStrength) and supplemental benefit enablers (FlexCard OTC/food allowances, Thrive Mobile smartphones with weekly check-ins, Delta Dental, Project Angel Heart post-discharge meals, vision and hearing benefits) sit on top of the core plan products, primarily to support Medicare Advantage retention.

Revenue is generated almost entirely through recurring monthly premiums (subscription-style) with pharmacy-related transaction fees. Distribution combines direct-to-consumer enrollment via the portal, phone-based health plan services, in-person enrollment at Denver Health facilities, licensed insurance brokers for Medicare and individual/family plans, the state Health First Colorado channel for Medicaid and CHP+, and a dedicated enrollment line for DHHA Hospital Authority employees. The company explicitly positions as a nonprofit directing surplus toward member well-being rather than shareholders, with embedded cost advantages at Denver Health pharmacies (50-75% prescription discounts) for HMO and DHHA employer cohorts. Revenue is not publicly disclosed.

Name

Denver Health Medical Plan

Legal name

Denver Health Medical Plan, Inc.

Website

https://denverhealthmedicalplan.org

Company type

Private

Founded year

1997

Operating status

Operating

Headcount range

51–100 employees

Short description

Denver Health Medical Plan is a Colorado nonprofit health insurance carrier founded in 1997 that administers Medicare Advantage (including D-SNP), Medicaid, CHP+, Exchange/CO Option, and DHHA employer plans for more than 100,000 members across the Denver metropolitan area.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Health Care and Social Assistance (62)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)

akta.pro secondary industries

CO-OP / Nonprofit Individual Market Plans (HLAEABAH), Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)

Keywords

• Health insurance plans
• Medicare Advantage
• Medicaid coverage
• HMO health plans
• POS health plans

Headquarters

HQ city

Denver

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Healthcare or R&D, Technology or R&D, Marketing or Sales, Supply Chain, Others

Revenue model

1. Health Insurance Premiums: Premium-based revenue from multiple plan types: Individual/Family Exchange plans, Medicare Advantage plans, CHP+ (Child Health Plan Plus), Medicaid, and employer group plans. Members and/or employers pay monthly premiums in exchange for health coverage.
2. Pharmacy Services: Pharmacy benefit management through MedImpact with tiered copay structure. Revenue generated from pharmacy dispensing and through manufacturer coupon programs and financial assistance coordination.

Pricing tiers

Go-to-market motion3 records

Distribution channels6 records

Marketing channels6 records

Core offering

Denver Health Medical Plan is a nonprofit health insurance carrier that provides comprehensive health insurance coverage including Individual & Family Exchange plans, Medicare Advantage (Elevate Medicare Choice HMO D-SNP and Elevate Medicare Select), Child Health Plan Plus (CHP+), Medicaid managed care (Elevate Medicaid Choice), and employer-sponsored DHHA Plans (HMO and POS). The plans are integrated with the Denver Health provider network and include preventive care, telehealth, pharmacy benefits, mental health services, and supplemental benefits such as dental, vision, hearing, transportation, and wellness programs.

Product overview

Denver Health Medical Plan is a nonprofit health insurance carrier serving the Denver metro community since 1997 with over 100,000 members. The company offers a comprehensive portfolio of health insurance products including Elevate Exchange/CO Option plans for individuals and families, Elevate Medicare Advantage (including Medicare Choice HMO D-SNP and Medicare Select plans), Elevate Child Health Plan Plus (CHP+), Elevate Medicaid Choice, and DHHA Employer Plans (Denver Health Plan HMO and Denver Health Extended Plan POS). The product portfolio extends across digital member services (MyDHMP Portal, MyChart integration, telehealth), pharmacy services (Denver Health Pharmacy by Mail, MedImpact Direct Mail through Birdi), mental health and wellness support (myStrength, Wellframe, behavioral health benefits), and supplemental benefits including FlexCard for OTC and food allowances, transportation through MTM, dental through Delta Dental, vision, hearing, home-delivered meals via Project Angel Heart, and Thrive Mobile phone program. The company also provides care coordination tools, 24/7 NurseLine, DispatchHealth in-home urgent care, and gender-affirming care services.

Differentiator

Problem solved

Functional benefit

Products and services

• Elevate Exchange/CO Option Individual and family health insurance plans offered through Colorado's health insurance exchange and Colorado Option for residents in Adams, Arapahoe, Denver, Jefferson, Larimer, Morgan, Park, and Weld counties.
• Elevate Medicare Advantage Medicare-approved HMO plan for individuals with Medicare Parts A and B living in Denver, Adams, Arapahoe, or Jefferson County. Includes Elevate Medicare Choice (HMO D-SNP) and Elevate Medicare Select plan options.
• Elevate Child Health Plan Plus (CHP+) Low-cost health plan for children through age 18 and pregnant people living in Denver, Jefferson, Arapahoe, or Adams counties who are approved for CHP+.
• Elevate Medicaid Choice Medicaid managed care plan for members who qualify for Medicaid coverage, assigned through Health First Colorado.
• Denver Health Plan (HMO) DHHA employer health plan with lowest monthly premiums and copays, providing access to the entire Denver Health provider network including 230+ primary care providers and 800+ specialists.
• Denver Health Extended Plan (POS) DHHA employer health plan with the largest choice of providers including Denver Health, Advent Health, UCHealth, CU Medicine, Children's Hospital Colorado, Intermountain Health, and First Health nationwide.
• Denver Health Pharmacy by Mail Mail-order prescription delivery service for medications written by Denver Health providers, with up to 90-day supplies available.
• MedImpact Direct Mail Pharmacy (Birdi) Mail-order pharmacy through Birdi for up to 90-day supply of maintenance medications with refill reminders and after-hours pharmacist support.
• Mental Health Benefits Coverage for mental health, behavioral health, and substance use disorder services including inpatient and outpatient care through in-network providers.
• FlexCard Prepaid benefit card providing over-the-counter allowances, healthy food allowances for qualifying members, and annual wellness visit rewards for Medicare Advantage members.
• Transportation Benefits Non-emergency medical transportation with 24 one-way trips per year for Medicare Advantage members, scheduled through MTM via phone, web, or app.
• Dental Benefits Dental coverage through Delta Dental of Colorado including two oral exams, cleanings, fluoride treatment, and bitewing X-rays per year.
• Vision Benefits Annual routine eye exam, allowance for contact lenses and/or eyeglasses, and cataract surgery coverage with intraocular lens and post-surgery eyewear.
• Hearing Benefits Supplemental routine hearing exam every three years, hearing aids every three years, and fitting evaluations for qualifying Medicare Advantage members.
• Thrive Mobile Phone Free smartphone with unlimited talk, text, and data for qualifying Medicare Choice (HMO D-SNP) members with chronic conditions, on T-Mobile network.
• DispatchHealth In-Home Urgent Care In-home urgent care service treating range of injuries and illnesses at home, available 7 a.m. to 10 p.m., 365 days a year.
• 24/7 NurseLine 24-hour nurse hotline available to answer health questions and call in certain prescriptions.
• Gender-Affirming Care Coverage for gender dysphoria treatment including mental health therapy, hormone therapy, mastectomy, breast augmentation, facial and lower-body surgeries, and related services.

Quantifiable outcome

• Preventive care covered at no charge on all plans
• +2 more outcomes

Named customers1 record

Segments5 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration16 records

AI capability4 records

Feature4 records

Partnerships

16 partnerships are on record, tiered core and minor.

• MedImpactcoreTechnology or IntegrationPharmacy benefit manager (PBM) providing drug pricing tools, pharmacy directory, mail-order pharmacy services through Birdi, and utilization management including prior authorization criteria and step therapy requirements.
• Delta Dental of ColoradocoreTechnology or IntegrationDental benefit administrator for Elevate Medicare Advantage members, providing access to Delta Dental Medicare Advantage PPO Network with coverage for oral exams, cleanings, fluoride treatments, and x-rays.
• MCG (MCG Care Guidelines)coreTechnology or IntegrationClinical care guidelines used to review medical necessity for health service requests. Evidence-based guidelines developed in accordance with randomized controlled trials, meta-analyses, and systematic reviews.
• MTM (Medical Transportation Management)coreStrategic or Co-development PartnerNon-emergency medical transportation provider for Medicare Advantage members, offering 24 one-way trips per year to plan-approved health-related locations including provider appointments and pharmacies. Uses Uber, Lyft, and wheelchair-accessible vehicles.
• DispatchHealthcoreStrategic or Co-development PartnerIn-home urgent care provider treating range of injuries and illnesses at members' homes, available 7 a.m. to 10 p.m., 365 days a year. Partnership for convenience-focused urgent care delivery.
• Project Angel HeartminorStrategic or Co-development PartnerHome-delivered meals nonprofit for Medicare Choice members post-inpatient or skilled nursing discharge. Provides 14 nutritious meals within 10 days of facility admission, prepared frozen entrees designed for nutritional needs.
• Thrive MobilecoreTechnology or IntegrationSmartphone benefit provider for Elevate Medicare Choice (HMO D-SNP) members with qualifying chronic conditions. Offers no-cost smartphone with unlimited talk/text/data, T-Mobile network, and preloaded health apps.
• UCHealthcoreTechnology or IntegrationProvider network partner for Medicare Advantage and Extended Plan members in Denver metro area.
• Intermountain HealthcoreTechnology or IntegrationProvider network partner for Medicare Advantage and Extended Plan members in Denver metro area.
• National Jewish HealthcoreTechnology or IntegrationProvider network partner for Medicare Advantage members in Denver metro area.
• Stride Community Health CenterscoreTechnology or IntegrationProvider network partner for Medicare Advantage members in Denver metro area.
• Children's Hospital ColoradocoreTechnology or IntegrationProvider network partner for Extended Plan members at front range locations.
• Advent HealthcoreTechnology or IntegrationProvider network partner for Extended Plan members at front range locations.
• SondermindcoreTechnology or IntegrationMental health provider network for Medicare Advantage members.
• WellPowercoreTechnology or IntegrationMental health provider network for Medicare Advantage members.
• First HealthcoreTechnology or IntegrationNational provider network for Extended Plan members and outpatient services for HMO and Exchange/CO Option plans.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Molina Healthcare: Medicaid and government-program managed care company. Comparable to DHMP's Medicaid and D-SNP lines, broker distribution, and reliance on capitation revenue from public payers.
• Kaiser Permanente: Integrated payer-provider nonprofit serving members across multiple geographies. Directly comparable to DHMP's integrated delivery + insurance model and nonprofit member-first orientation.
• Centene Corporation: Largest Medicaid managed care operator in the U.S. DHMP's Elevate Medicaid Choice, Exchange, and Medicare offerings match Centene's portfolio scale and government-channel go-to-market.
• CareSource: Nonprofit managed care plan focused on Medicaid and government programs. Closely mirrors DHMP's nonprofit, member-focused, government-line orientation.
• Health Net: Medicaid, Medicare, and commercial health plan with state-contract managed care products. Comparable product mix to DHMP across Medicaid, MA, and Exchange lines.
• Rocky Mountain Health Plans: Colorado-based nonprofit health plan serving Medicaid, Medicare, and commercial members. Most direct geographic peer to DHMP, operating in overlapping Colorado counties with a similar nonprofit model.
• Blue Shield of California: Nonprofit health plan serving Medi-Cal, Medicare, and commercial members. Comparable to DHMP's nonprofit governance, broker distribution, and multi-segment product portfolio.

Broad incumbents

• Anthem Blue Cross Blue Shield Colorado: Largest Colorado health insurer offering commercial, Medicare, and Medicaid products. Competes directly against DHMP but operates as part of a much broader multi-state portfolio with greater scale.
• UnitedHealthcare Colorado: National carrier with significant Medicare Advantage and Medicaid presence in Colorado. Competes against DHMP across multiple lines with vastly larger scale and provider network.
• Humana: Leading Medicare Advantage carrier with growing D-SNP and supplemental benefits portfolio. Directly comparable to DHMP's Elevate Medicare Choice and supplemental FlexCard/transportation/meal stack.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Denver Health Medical Plan