Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

RMHP Valley Colorado Option Silver

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

Silver
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$11,450
Family OOP max
$22,900

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

Monthly premiums by age

Rating Area 7 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$416$416
21$544$571
30$617$679
40$695$764
50$971$1,116
60$1,475$1,696
64 and over$1,631$1,875

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or IllnessNo charge

Specialist

BenefitIn-network
Specialist Visit$90.00

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$80.00

Pharmacy

BenefitIn-network
Non-Preferred Generic Drugs$125.00
Generic Drugs$20.00
Medical Service Drugs40.00% Coinsurance after deductible
Non-Preferred Brand Drugs$300.00
Preferred Brand Drugs$125.00
Preventive DrugsNo charge
Specialty Drugs$650.00

Mental Health

BenefitIn-network
Intensive Outpatient for Mental/Behavioral Health40.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder40.00% Coinsurance after deductible
Mental Health Wellness VisitNo charge
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Prenatal CareNo charge
Office Visit - Mental/Behavioral HealthNo charge
Office Visit - Substance Use DisorderNo charge
Partial Hospitalization for Mental/Behavioral Health40.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder40.00% Coinsurance after deductible
Postpartum Mental/Behavioral HealthNo charge
Postpartum Substance Use DisorderNo charge
Residential Day Treatment for Mental/Behavioral Health40.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder40.00% Coinsurance after deductible
Substance Use Disorder Prenatal CareNo charge
Telehealth Mental/Behavioral HealthNo charge
Telehealth Substance Use DisorderNo charge

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
AcupunctureSee plan details
Allergy Testing40.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies40.00% Coinsurance after deductible
Autism Spectrum Disorders - Assessment and Evaluation Services$90.00
Bariatric Surgery40.00% Coinsurance after deductible
Basic Dental Care - ChildNo charge
Chemotherapy40.00% Coinsurance after deductible
Chiropractic CareNo charge
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Education$5.00
Diabetic SuppliesNo charge
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for Children40.00% Coinsurance after deductible
Gender Affirming Care40.00% Coinsurance after deductible
Habilitation Services40.00% Coinsurance after deductible
Hearing Aids40.00% Coinsurance after deductible
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility Treatment40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Inpatient Rehabilitation40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
Major Dental Care - ChildNo charge
Nutritional Counseling40.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services40.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty Nursing40.00% Coinsurance after deductible
Prosthetic Devices40.00% Coinsurance after deductible
Prosthetics: Legs and Arms20.00%
Prosthetics: Recreational40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy40.00% Coinsurance after deductible
Rehabilitative Occupational Therapy40.00% Coinsurance after deductible
Rehabilitative Physical Therapy40.00% Coinsurance after deductible
Rehabilitative Speech Therapy40.00% Coinsurance after deductible
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility40.00% Coinsurance after deductible
Standalone Laboratory40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services40.00% Coinsurance after deductible
Telehealth PCPNo charge
Telehealth Specialist$90.00
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Service area

This plan covers 28 geographic areas.

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