PARTC

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C)
Insurance Provider
Rocky Mountain Health Plan
CMS Rating
Plan Type
Cost
Annual Deductible
$0.00

What To Know About This Plan

  • This is a health coverage only plan with no drug coverage

All cost-sharing assumes in-network healthcare providers.

Plan Details

Costs and Other Important Information

Plan Year:
2016
Monthly Drug Plan Premium
Not Applicable
Health Plan Deductible
$600 In-network
Choice of Doctors?
Plan Doctors for Most Services
Monthly Health Plan Premium
$20.00
Out-Of-Pocket Spending Limit
$6,700 In-network
Optional Supplemental Benefits?
Yes
Prescription Drugs Covered?
No
Other Health Plan Deductibles?
Yes

Benefits

Service
Cost
Ambulance
$200
Doctor's office visits
Primary Physician
$25 per visit
Specialist
$55 per visit
Durable medical equipment (wheelchairs, oxygen, etc.)
20% per item
Emergency care
$75 per visit (always covered)
Home health care
You pay nothing
Mental health care
$350 for days 1 through 7
$0 for days 8 through 90
Outpatient hospital
$400 per visit
Renal dialysis
20% per visit
Inpatient hospital care
$350 for days 1 through 7
$0 for days 8 through 90
Skilled Nursing Facility (SNF)
$0 for days 1 through 20
$100 for days 21 through 100

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical
Not Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
Appeals auto-forward
Appeals upheld
Not Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept Rocky Mountain Green (Cost) for Colorado

/
MCNAMEE, MEGAN
75 MEADE ST
DENVER, CO 80219
NGUYEN, LISA
8015 W ALAMEDA
LAKEWOOD, CO 80226
MOLINA, WILSON
777 BANNOCK ST
DENVER, CO 80204
MEYER, PATRICIA
777 BANNOCK ST
DENVER, CO 80204
HELLER, JULIE
777 BANNOCK ST
DENVER, CO 80204
SMITH, SAMUEL
777 BANNOCK ST
DENVER, CO 80204
LIVERMORE, MERYL
777 BANNOCK ST # MC0188
DENVER, CO 80204
KAPLAN, BONNIE
777 BANNOCK ST
DENVER, CO 80204
LAGRENADE, KEITH
3520 W OXFORD AVE
DENVER, CO 80236
DREILING, LISA
5225 W JEWELL AVE
LAKEWOOD, CO 80232
LEON, DAVID
2020 WADSWORTH BLVD
LAKEWOOD, CO 80214
BURNS, EDITH
2405 WADSWORTH BLVD
LAKEWOOD, CO 80214
CONRY, COLLEEN
3055 ROSLYN ST
DENVER, CO 80238
MONTGOMERY, LINDA
3055 ROSLYN ST
DENVER, CO 80238
MADIGOSKY, WENDY
3055 ROSLYN ST
DENVER, CO 80238
DAR, HUNAIF
535 16TH ST
DENVER, CO 80202
HUUN, MARK
1515 WAZEE ST
DENVER, CO 80202
ATENCIO, STEPHANIE
535 16TH ST
DENVER, CO 80202
BLITZ, SCOTT
7550 W YALE AVE
DENVER, CO 80227
PANOZZO, JOHN
7550 W YALE AVE
DENVER, CO 80227
DOYLE, ROBERT
7550 W YALE AVE
DENVER, CO 80227
GEHRKE, MICHAEL
333 W HAMPDEN AVE
ENGLEWOOD, CO 80110
MUKHERJEE, GOPA
1634 DOWNING ST
DENVER, CO 80218
HUANG, LINDA
1601 E 19TH AVE
DENVER, CO 80218
MARTZ, GARY
1721 E 19TH AVE
DENVER, CO 80218
Details
MEGAN MCNAMEE, MD
Phone Number
(303) 504-1900
Office Locations
75 MEADE ST
DENVER, CO 80219
75 MEADE ST DENVER CO, 80219

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