Need Coverage? (800) 453-2981 (Individuals) (970) 683-5630 (Employers) Provider Directory

Getting coverage

You need health insurance. Not only is it smart: It’s the law.

The Affordable Care Act requires all individuals to have health insurance or pay a tax penalty. In 2016, that penalty was $695 per person ($347.50 per child under 18) or 2.5 percent of your yearly household income, whichever is greater. (There are exceptions.)

Employers generally offer insurance to full-time employees. But if you are not covered by your employer, you will need to buy your own. How?

  • You can buy directly from Rocky Mountain Health Plans. Call 1-800-453-2981 to speak to a representative who can explain your options.
  • You can work with a local broker (download the list) who has special expertise and experience in helping people purchase health insurance.
  • You can buy coverage through the state insurance exchange, Connect for Health Colorado.

Choosing a plan

There are three major factors for choosing a health plan: cost, your own health status, and the network of providers included in the plan.

11

How much will it cost?

The most obvious cost is the monthly premium, the monthly amount you pay to have health insurance. But a low premium isn’t the best choice for everyone, and it’s certainly not the only cost to consider. There are out-of-pocket cost factors that come into play when you use health services.

Out-of-pocket costs include

  • Copay – the fee you pay each time you visit a doctor or other healthcare provider;
  • Deductible – the amount you pay before your insurance begins to pay.
  • Co-insurance – the percentage of costs that you will pay. For instance, your plan may pay 80% of the agreed-upon charges, while you pay 20%.

It’s important to also look for the out-of-pocket maximum, or the most money your insurance plan requires you to pay over a plan year. After you reach this amount, your insurance plan pays the full cost for services.

22

How much health care do I expect to use?

  • If you plan to have a baby soon, or you or a family member has a chronic condition that requires  a higher monthly premium and regular treatment, you may prefer a plan with fewer out-of-pocket costs.
  • If you are generally healthy, you may want to choose a lower monthly premium plan that has a higher deductible. You’ll still be protected against a medical catastrophe, but you’ll pay more if you do encounter unexpected illness or injury.
33

Are my providers in the plan network?

There are 120+ primary care providers. Three hospitals, and over 300 specialists in the Monument Health network. These are the tier 1 providers where care is the most coordinated and costs are most affordable.

You many still see tier 2 providers or those who are “out of network.”

MORE RESOURCES

Families USA offers a variety of tools to help you decide on the type of coverage you need.

Fairhealthconsumer.org also offers resources for choosing the best health plan for you.

Want to learn more? See the Monument Health Products or download the 2017 Individual Plan coverage details.

Questions?
Call us. 970.683.5630

Ready to buy?
Call RMHP. 800.453.2981

Search