Select Health Value Gold $2200 Medical Deductible HDHP/HSA Qualified

SelectHealth, Inc. · 2027 plan year

GoldHSA eligible

Ind. deductible: $2,200
Family deductible: $4,400
Ind. OOP max: $8,700
Family OOP max: $17,400

Compare with other Gold plans in CO

Side by side: deductibles, out-of-pocket limits and copays.

RMHP Monument One Gold Value ($0 Virtual UC, $8 Tier 2 Rx, $0 Insulin, No Referrals, Rx Copay)Rocky Mountain Health Maintenance Organization, Inc. · Deductible $2,000 · Out-of-pocket max $9,500
RMHP Colorado Doctors Plan Gold Value ($0 Virtual UC, $8 Tier 2 Rx, $0 Insulin, No Referrals, Rx Copay)Rocky Mountain Health Maintenance Organization, Inc. · Deductible $2,000 · Out-of-pocket max $9,500
RMHP Valley Gold Value ($0 Virtual UC, $8 Tier 2 Rx, $0 Insulin, No Referrals, Rx Copay)Rocky Mountain Health Maintenance Organization, Inc. · Deductible $2,000 · Out-of-pocket max $9,500

Compare 4 plans Browse all Gold plans in CO

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Gold Off Exchange Plan Zero Cost Sharing Plan Variation

More SelectHealth, Inc. plans in CO

Select Health Value Colorado Option Bronze HSA Eligible Select Health Monument Value Colorado Option Bronze HSA Eligible Select Health Value Bronze $6900 Medical Deductible HSA Eligible Select Health Monument Value Bronze $6900 Medical Deductible HSA Eligible Select Health Value Bronze $8500 Medical Deductible HSA Eligible

Monthly premiums by age

Rating Area 4 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$414	$414
21	$541	$541
30	$614	$614
40	$692	$740
50	$967	$1,063
60	$1,469	$1,689
64 and over	$1,624	$1,867

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	No Charge after deductible

Specialist

Benefit	In-network
Specialist Visit	No Charge after deductible

Hospital

Benefit	In-network
Urgent Care Centers or Facilities	No Charge after deductible
Emergency Room Services	20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	20.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	No Charge after deductible
Medical Service Drugs	50.00% Coinsurance after deductible
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Non-Preferred Generic Drugs	No Charge after deductible
Preferred Brand Drugs	15.00% Coinsurance after deductible
Preventive Drugs	No charge
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Intensive Outpatient for Mental/Behavioral Health	20.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder	20.00% Coinsurance after deductible
Mental Health Wellness Visit	No charge
Mental/Behavioral Health Inpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	No Charge after deductible
Mental/Behavioral Health Prenatal Care	No Charge after deductible
Office Visit - Mental/Behavioral Health	No Charge after deductible
Office Visit - Substance Use Disorder	No Charge after deductible
Partial Hospitalization for Mental/Behavioral Health	20.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder	20.00% Coinsurance after deductible
Postpartum Mental/Behavioral Health	No Charge after deductible
Postpartum Substance Use Disorder	No Charge after deductible
Residential Day Treatment for Mental/Behavioral Health	20.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder	20.00% Coinsurance after deductible
Substance Use Disorder Prenatal Care	No Charge after deductible
Telehealth Mental/Behavioral Health	No Charge after deductible
Telehealth Substance Use Disorder	No Charge after deductible

Other

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

Service area

This plan covers 17 geographic areas.

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