2016 Individual & Family PPO Health Insurance Plans

Rocky Mountain Health Plans’ Individual & Family health insurance provides unlimited office visits with a pre-determined co-pay amount as well as full coverage for preventative screening and exams.  No matter you or your family’s personal health care needs, there’s a plan to match.  See the PPO health plan options found below to choose the plan that’s right for you and your family.  

New for 2016: Rocky Mountain Rio Individual and Family Plans

RMHP Members can enjoy full access to our entire statewide network; online resources, including access to convenient, cost-savings tools and services like the Cost Estimator and MyDigitalMD; holistic care, including chiropractic and acupuncture services; and much more.

Rocky Mountain Rio plans are available in these Western Slope counties:

Archuleta         
Delta
Dolores
Eagle
Garfield
Grand
Gunnison
Hinsdale
Jackson
La Plata
Lake
Mesa
Moffat
Montezuma       
Montrose
Ouray
Pitkin
Rio Blanco
Routt
San Juan
San Miguel
Summit



RM rio

Rocky Mountain Rio - Individual Plans

Plan Name

Deductible Individual / Family

Office Visits

Inpatient Hospital Stay (after deductible)

Out of Pocket Maximum Individual / Family

Prescription Drug Coverage 

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  In Network Out of Network In Network Out of Network In Network Out of Network In Network Out of Network  In Network
Out of Network

 

Rio PPO Gold 500/$35

SBC/Summary of Benefits

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$500/
$1,000
$1,000/
$2,000
$35/$50
no deductible
50% after deductible 20% coinsurance 50% coinsurance $4,000/
$8,000
$8,000/
$16,000
Tier 1: $15
Tier 2: $45
Tier 3: $70
Tier 4: $250
Tier 5: $330
(no deductible)

Drug Price Check

Not covered

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Rio PPO Gold 900/$35

SBC/Summary of Benefits

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$900/
$1,800
$1,800/
$3,600
$35/$50
no deductible
50% after deductible 20% coinsurance

50% coinsurance

$4,100/
$8,200
$8,200/
$16,400
Tier 1: $15
Tier 2: $40
Tier 3: 20%
Tier 4: 30%
Tier 5: 40%
(no deductible)


Drug Price Check

Not covered

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Rio PPO Silver 1500/$40

SBC/Summary of Benefits

View EOC
$1,500/
$3,000
$3,000/
$6,000
$40/$55
no deductible
50% after deductible 30% coinsurance 50% coinsurance $6,650/
$13,300
$13,300/
$26,600
Tier 1: $15
Tier 2: $55
Tier 3: $200
Tier 4: $400
Tier 5: $540
(no deductible)


Drug Price Check

Not covered

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Rio PPO Silver 2500/$40

SBC/Summary of Benefits

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$2,500/
$5,000
$5,000/
$10,000
$40/$55
no deductible
50% after deductible 30% coinsurance 50% coinsurance $6,600/
$13,200
$13,200/
$26,400
No Deductible:
Tier 1: $15
Tier 2: 30%
After $500 Rx Deductible:
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%

Drug Price Check
Not covered

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Rio PPO Silver HSA 2800/100%

SBC/Summary of Benefits

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$2,800/
$5,600
$5,600/
$11,200
100% covered after deductible 50% after deductible 100% covered 50% coinsurance $5,000/
$10,000

$10,000/
$20,000

After Deductible
Tier 1: $15
Tier 2: $45
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%

Drug Price Check
Not covered

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Rio PPO Silver HSA 3500/100%

SBC/Summary of Benefits

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$3,500/
$7,000

$7,000/
$14,000
100% covered after deductible 50% after deductible 100% covered 50% coinsurance $3,500/
$7,000
$14,000/
$28,000
After Deductible
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Drug Price Check
Not covered

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Rio PPO Silver 4000/$40

SBC/Summary of Benefits

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$4,000/
$8,000

$8,000/
$16,000

$40/$55
no deductible
50% after deductible 30% coinsurance 50% coinsurance $6,000/
$12,000
$12,000/
$24,000
Tier 1: $15
Tier 2: $45
Tier 3: $175
Tier 4: $350
Tier 5: $500
(no deductible)

Drug Price Check

Not covered

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Rio PPO Bronze HSA 5050/100%

SBC/Summary of Benefits

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$5,050/
$10,100
$10,100/
$20,200
100% covered after deductible 100% covered after deductible 100% covered 100% covered $6,550/
$13,100

$13,100/
$26,200

After Deductible:
Tier 1: $25
Tier 2: $70
Tier 3: $300
Tier 4: $450
Tier 5: $540

Drug Price Check

Not covered

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Rio PPO Bronze HSA 6550/100%

SBC/Summary of Benefits

View EOC


$6,550/
$13,100
$13,100/
$26,200

100% covered after deductible

100% covered after deductible 100% covered 100% covered $6,550/
$13,100
$26,200/
$52,400
After Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Drug Price Check

Not covered

Get Quote

Rio PPO 6850/$45

SBC/Summary of Benefits

View EOC
$6,850/
$13,700
$13,700/
$27,400
PCP: First 3 visits: $45
no deductible, then 100% covered after deductible
Specialist:
100% covered after deductible
100% covered after deductible 100% covered

100% covered

$6,850/
$13,700
$27,400/
$54,800
After Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%

Drug Price Check

Not covered

Get Quote

2015 Rocky Mountain View PPO Individual Plans

Plan
Name

Deductible Individual / Family

Office Visits

Inpatient Hospital Stay (after deductible)

Out of Pocket Maximum Individual / Family

 Prescription Drug Coverage

Get Quote

View PPO Gold
500/$35

View SBC

View Benefit Summary

In Network
$500/ $1,000

Out of Network
$1,000/ $2,000

In Network
$35/
$50
no deductible

Out of Network
50% covered after deductible

In Network
20% coinsurance

Out of Network
50% coinsurance

In Network
$4,000/ $8,000

Out of Network
$8,000/ $16,000

In Network
Tier 1: $15
Tier 2: 20%
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%
(no deductible)


Out of Network
Not covered

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View PPO Silver 
1500/ $40


View SBC

View Benefit Summary

In Network
$1,500/ $3,000

Out of Network
$3,000/ $6,000

In Network
$40/
$55
no deductible

Out of Network
50% covered after deductible

In Network
30% coinsurance

Out of Network
50% coinsurance

In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400

In Network
Tier 1: $15
Tier 2: 30%
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%
(no deductible)


Out of Network
Not covered

Get Quote

View PPO Silver 
2500/$40


View SBC

View Benefit Summary

In Network
$2,500/ $5,000

Out of Network
$5,000/ $10,000

In Network
$40/
$55
no deductible

Out of Network
50% covered after deductible

In Network
30% coinsurance

Out of Network
50% coinsurance


In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400

In Network
No Deductible:
Tier 1: $15
Tier 2: 30%
After $500 Rx Deductible:
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%

Out of Network
Not covered

Get Quote

View PPO Silver 
3000/$40


View SBC

View Benefit Summary
In Network
$3,000/ $6,000

Out of Network
$6,000/ $12,000

In Network
$40/
$55
no deductible

Out of Network
50% covered after deductible

In Network
30% coinsurance

Out of Network
50% coinsurance


In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400

In Network
 No Deductible:
Tier 1: $15
Tier 2: 30%
After $2,000 Rx Deductible:
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%


Out of Network
Not covered

Get Quote

View PPO Silver HSA
2500/100%

View SBC

View Benefit Summary

In Network
$2,500/ $5,000

Out of Network
$5,000/ $10,000

In Network
100% covered after deductible

Out of Network
50% covered after deductible

In Network
100% covered

Out of Network
50% coinsurance

In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400

 In Network
After Deductible
Tier 1: 0%
Tier 2: 0%
Tier 3: 30%
Tier 4: 40%
Tier 5: 50%


Out of Network
Not covered

Get Quote

View
PPO Bronze
4500/$55


View SBC

View Benefit Summary

In Network
$4,500/ $9,000

Out of Network
$9,000/ $18,000

In Network
PCP: $55
no deductible
Specialist: 
40% coinsurance after deductible

Out of Network
50% covered after deductible

In Network
40% coinsurance

Out of Network
50% coinsurance

In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400

In Network
No Deductible:
Tier 1: $20
After Medical Deductible:
Tier 2: 40%
Tier 3: 40%
Tier 4: 50%
Tier 5: 50%


Out of Network
Not covered

Get Quote

View PPO Bronze 
5500/$60


View SBC

View Benefit Summary

In Network
$5,500/ $11,000

Out of Network
$11,000/ $22,000

In Network
PCP: $60
no deductible
Specialist: 
40% coinsurance after deductible

Out of Network
50% covered after deductible

In Network
40% coinsurance

Out of Network
50% coinsurance

In Network
$6,350/ $12,700

Out of Network
$12,700/ $25,400


In Network
No Deductible:
Tier 1: $25
After Medical Deductible:
Tier 2: 40%
Tier 3: 40%
Tier 4: 40%
Tier 5: 50%


Out of Network
Not covered

Get Quote

View PPO Bronze HSA 
6300/100%

View SBC

View Benefit Summary

In Network
$6,300/ $12,600

Out of Network
$12,600/ 
$25,200

In Network
100% covered after deductible

Out of Network
100% covered after deductible

In Network
100% covered

Out of Network
100% covered

In Network
$6,350/ $12,600

Out of Network
$12,600/ $25,200


In Network
After Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%


Out of Network
Not covered

Get Quote

View PPO
6600/$45


View SBC

View Benefit Summary

In Network
$6,600/ $13,200

Out of Network
$13,200/ 
$26,400

In Network
PCP:  First 3 visits: $45
no deductible, then 100% covered after deductible
Specialist: 
100% covered after deductible

Out of Network
100% covered after deductible

In Network
100% covered

Out of Network
100% covered

In Network
$6,600/ $12,700

Out of Network
$13,200/ $26,400

In Network
After Deductible:
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%
Tier 5: 0%


Out of Network
Not covered

Get Quote

View a Printable Comparison of the 2016 Plans

Click here to view the Rocky Mountain Rio Product Brochure

Click here to view the RMHP Summit Group and Rio Individual Plans Directory

RMHP Individual and Family Members have access to our national network through First Health. Learn more about our National Network Access.