Colorado Doctors Plan Bronze 6500 $3 Walgreens Plan Details for 2021- HealthPocket

Colorado Doctors Plan Bronze 6500 $3 Walgreens

$290.38/mo

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Zip Code80219
Applicant8/8/1987 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameColorado Doctors Plan Bronze 6500 $3 Walgreens
Plan IDhhs-97879CO0420029
Plan Year2021
Insurance ProviderRocky Mountain Health Plan
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,500
Out-of-Pocket Maximum$8,700
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$25 Copay
Specialist Visit40% Coinsurance after deductible
Laboratory Outpatient and Professional Services40% Coinsurance after deductible
X-rays and Diagnostic Imaging40% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans40% Coinsurance after deductible
Deductible - Family$13000 per group
Out-of-Pocket Maximum - Family$17400 per group

Prescription drug coverage

Generic Drugs$35 Copay
Preferred Brand Drugs40% Coinsurance after deductible
Non-Preferred Brand Drugs40% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.rmhp.org
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?No -
Does this plan cover services outside plan service area?Yes - Urgent/Emergent Only
Does this plan cover services outside the country?Yes - Urgent/Emergent Only

Hospital services

Emergency Room Services50% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible
Emergency Transportation or Ambulance Service40% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care40% Coinsurance after deductible
Delivery and all inpatient services for maternity care40% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services40% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services40% Coinsurance after deductible
Substance use disorder outpatient services40% Coinsurance after deductible
Substance use disorder inpatient services40% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Diabetes, Heart Disease
Does this plan offer a wellness program?Covered

Vision Coverage

Routine Eye Exam for ChildrenCovered
Eye Glasses for ChildrenCovered
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareCovered
Child Dental Coverage - Basic Dental CareCovered
Child Dental Coverage - OrthodontiaCovered
Child Dental Coverage - Major Dental CareCovered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Bariatric Surgery
Infertility Treatment
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
Applied Behavior Analysis Based Therapies
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Prosthetics: Legs and Arms
Telehealth PCP
Telehealth Specialist
Intensive Outpatient for Substance Use Disorder
Mental/Behavioral Health Prenatal Care
Partial Hospitalization for Mental/Behavioral Health
Partial Hospitalization for Substance Use Disorder
Postpartum Mental/Behavioral Health
Postpartum Substance Use Disorder
Residential Day Treatment for Mental/Behavioral Health
Residential Day Treatment for Substance Use Disorder
Substance Use Disorder Prenatal Care
Telehealth Mental/Behavioral Health
Telehealth Substance Use Disorder
Autism Spectrum Disorders - Assessment and Evaluation Services
Intensive Outpatient for Mental/Behavioral Health
More Limited BenefitsSkilled Nursing Facility
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Rehabilitative Occupational Therapy
Rehabilitative Physical Therapy
Inpatient Rehabilitation
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $260Oscar Bronze Classic ($3 Prescription List + Free 24/7 Virtual$6,300.00Select
from $274Colorado Doctors Plan Bronze 6500$6,500.00Select
from $279KP Select CO Bronze 6500/50$6,500.00Select
from $280Silver 6700 Direct$6,700.00Select
from $284Bronze Classic (Colorado Partners Choice) ($0 Virtual Care + $3 Drugs)$6,500.00Select
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  • Phone Number
    (303) 935-9142
  • Office Locations
    1930 S Federal Blvd
    Denver, CO 80219
1930 S Federal Blvd Denver CO, 80219

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HealthPocket.com is a free information source. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.