RMHP Valley Colorado Option Bronze

Rocky Mountain Health Maintenance Organization, Inc. · 2027 plan year

Expanded BronzeHSA eligible

Ind. deductible: $8,100
Family deductible: $16,200
Ind. OOP max: $11,200
Family OOP max: $22,400

Other cost-sharing reduction variants for this plan:

Standard Bronze Off Exchange Plan Standard Bronze On Exchange Plan Zero Cost Sharing Plan Variation

More Rocky Mountain Health Maintenance Organization, Inc. plans in CO

RMHP Monument Health Gold Value ($0 Virtual UC, $5 Tier 2 Rx, $0 Insulin, No Referrals, Rx Copay)RMHP Monument Health Silver Advantage ($0 Virtual UC, $7 Tier 2 Rx, $0 Insulin, No Referrals, Rx Copay)RMHP Monument Health Silver Value ($0 Virtual UC, $0 Insulin, No Referrals, Rx Copay)

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$50.00 Copay after deductible

Specialist

Benefit	In-network
Specialist Visit	50.00% Coinsurance after deductible

Hospital

Benefit	In-network
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	50.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	$30.00
Medical Service Drugs	50.00% Coinsurance after deductible
Non-Preferred Brand Drugs	$350.00
Non-Preferred Generic Drugs	$200.00
Preferred Brand Drugs	$200.00
Preventive Drugs	No charge
Specialty Drugs	$700.00

Mental Health

Benefit	In-network
Intensive Outpatient for Mental/Behavioral Health	50.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder	50.00% Coinsurance after deductible
Mental Health Wellness Visit	No charge
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Prenatal Care	No charge
Office Visit - Mental/Behavioral Health	No charge
Office Visit - Substance Use Disorder	No charge
Partial Hospitalization for Mental/Behavioral Health	50.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder	50.00% Coinsurance after deductible
Postpartum Mental/Behavioral Health	No charge
Postpartum Substance Use Disorder	No charge
Residential Day Treatment for Mental/Behavioral Health	50.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder	50.00% Coinsurance after deductible
Substance Use Disorder Prenatal Care	No charge
Telehealth Mental/Behavioral Health	No charge
Telehealth Substance Use Disorder	No charge

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	See plan details
Acupuncture	$50.00 Copay after deductible
Allergy Testing	50.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies	50.00% Coinsurance after deductible
Autism Spectrum Disorders - Assessment and Evaluation Services	50.00% Coinsurance after deductible
Bariatric Surgery	50.00% Coinsurance after deductible
Basic Dental Care - Child	See plan details
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$50.00 Copay after deductible
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	No charge
Diabetes Education	$5.00
Diabetic Supplies	No charge
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00% Coinsurance after deductible
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	50.00% Coinsurance after deductible
Gender Affirming Care	50.00% Coinsurance after deductible
Habilitation Services	50.00% Coinsurance after deductible
Hearing Aids	50.00% Coinsurance after deductible
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infertility Treatment	50.00% Coinsurance after deductible
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Inpatient Rehabilitation	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	50.00% Coinsurance after deductible
Major Dental Care - Child	See plan details
Nutritional Counseling	50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	$50.00 Copay after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Outpatient Rehabilitation Services	50.00% Coinsurance after deductible
Prenatal and Postnatal Care	$50.00 Copay after deductible
Private-Duty Nursing	50.00% Coinsurance after deductible
Prosthetic Devices	50.00% Coinsurance after deductible
Prosthetics: Legs and Arms	20.00%
Prosthetics: Recreational	50.00% Coinsurance after deductible
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	50.00% Coinsurance after deductible
Rehabilitative Occupational Therapy	50.00% Coinsurance after deductible
Rehabilitative Physical Therapy	50.00% Coinsurance after deductible
Rehabilitative Speech Therapy	50.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	50.00% Coinsurance after deductible
Standalone Laboratory	50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	50.00% Coinsurance after deductible
Telehealth PCP	$50.00 Copay after deductible
Telehealth Specialist	50.00% Coinsurance after deductible
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible

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