Rocky Mountain Basic Plan is a Medicare Advantage plan, from Rocky Mountain Health Plans, available in San Miguel County, Colorado. This is a Cost Contract option for people with Medicare. It offers the same healthcare benefits as original Medicare, but your out-of-pocket costs are based on the reasonable cost of providing services.
With this Cost plan you're not restricted to the plan's network of healthcare providers. Providers outside of the plan network are reimbursed by Medicare intermediaries and carriers.
This type of plan is available in limited areas around the country, including San Miguel County, Colorado. Plan members who use in-network providers will have lower costs and the most coverage. However, there's also an option to use out-of-network providers and be covered under Original Medicare, Part A and Part B. In this way, Rocky Mountain Basic Plan is like a traditional HMO with an escape clause.
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 5 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Not included with this plan.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
CRITICAL: With this plan, if you use out-of-network providers you will pay the Part A and Part B co-insurance and deductible.
NOTE: It may be possible to enroll in a Medicare Cost plan even if you only have Medicare Part B. Call 1-800-MEDICARE to see if you qualify.
How Much Does Rocky Mountain Basic Plan Cost?
The premium on this plan is $10.00 per month. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventative care mandated by CMS (see H0602-026 Summary of Benefits below).
IMPORTANT: When evaluating this plan, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Rocky Mountain Basic Plan plan MOOP is $- . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in San Miguel County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Medicare 5-Star Ratings
In this section we show you the quality rating for this Rocky Mountain Health Plans plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
Does Rocky Mountain Basic Plan include Medicare Part D?
This plan does not include prescription drug coverage. You can get prescription coverage by joining one of the Medicare Part D Plans in Colorado.
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services.
Rocky Mountain Basic Plan vs. Medigap
To compare Rocky Mountain Basic Plan with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide (opens in a new tab). It will help you understand how to compare Rocky Mountain Basic Plan with Medicare Supplement plans in Colorado. Medicare Plan F in Colorado is the most popular.
Contact Rocky Mountain Health Plans
For more information about this plan, call their prospective members line, or visit their website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov or the Wikipedia page.
Medicare Part C Plan Availability
Rocky Mountain Basic Plan is available to beneficiaries living in Egnar, Norwood, Ophir, Placerville, Telluride, and all other areas of San Miguel County, Colorado; Medicare plans are the same throughout the County.
The Medicare Advantage plan data on MedicareWire comes directly from CMS.gov and is subject to change. CMS has neither reviewed nor endorsed the information on this site.
The health insurance benefit information provided on this page is a brief summary only, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly at (888)282-1420 or (711)- for TTY users.
The MedicareWire website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional. On this page we help consumers research and compare:
Rocky Mountain Basic Plan for San Miguel County, Colorado is a 2019 Medicare Advantage Plan (Cost H0602-026), with a $10.00/mo premium and $- max out-of-pocket limit. Compare star ratings, benefits, premiums, co-pays, deductibles and prescription coverage with other Part C plans.
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This Medicare Advantage plan information is maintained by David Bynon and was last updated on .