Monument Health PPO plans are available in Mesa County. These tiered benefit plans offer preferred access to the Monument Health Network along with access to our statewide and national network of providers and facilities. No referrals are needed.
Why Choose a Monument Health Plan from RMHP?
Your employees can enjoy peace of mind with a Monument Health plan from RMHP with the value, personalized care, and dependability they expect and deserve. Our plans:
- Are designed for long-term, sustainable cost savings.
- Encourage Members to establish a medical home, leading to an ongoing, trusted relationship with a primary care provider in a practice that has been recognized for patient-centered care.
- Promote quality of care with whole-person and comprehensive care emphasized.
- Offer consistent care across the network, as Monument Health providers follow network-wide guidelines surrounding care coordination.
- Work with providers to demonstrate and regularly be measured on their performance.
To view coverage and deductible information for our Monument Health PPO Plans, review our PPO plan comparison grid below, or download our Monument Health PPO Highlights Flyer.
Download the Monument Health PPO service area map
Download the 2020 Monument Health PPO highlights flyer
Monument Health PPO Plans
Monument Health PPO Bronze HSA 6300/6350
Deductible Individual / Family
In-Network:
Tier 1: $6,300 Individual/$12,600 Family
Tier 2: $6,350 Individual/$12,700 Family
Out-of-Network:
$10,000/$20,000
Office Visits
In-Network: Tier 1/Tier 2:
PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible
MH: 0% coinsurance after deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network: Tier 1/Tier 2
0% coinsurance after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1/Tier 2: $6,750 Individual/$13,500 Family
Out-of-Network:
$15,000/$30,000
Prescription Drug Coverage
In-Network:
After Tier 1 Deductible:
Tier 1: 10%
Tier 2: 10%
Tier 3: 10%
Tier 4: 10%
Out-of-Network: Not covered
Monument Health PPO Bronze 6900/8050
Deductible Individual / Family
In-Network:
Tier 1: $6,900 Individual/$13,800 Family
Tier 2: $8,050 Individual/$16,100 Family
Out-of-Network:
$12,000/$24,000
Office Visits
In-Network:Tier 1: PCP: $60
Specialist: $130 Copay, no deductible
MH: $60 no deductible
Tier 2: PCP: $80 no deductible
Specialist: $180 no deductible
MH: $80 no deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network:
Tier 1: 40% after deductible
Tier 2: $500 per stay, then 50% after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1/Tier 2: $8,150 Individual/$16,300 Family
Out-of-Network:
$18,000/$36,000
Prescription Drug Coverage
In-Network:
No Deductible
Tier 1: $25
Tier 2: $60
Tier 3: $150
Tier 4: $350
Out-of-Network: Not covered
Monument Health PPO Silver HSA 4500/6000
Deductible Individual / Family
In-Network:
Tier 1: $4,500 Individual/$9,000 Family
Tier 2: $6,000 Individual/$12,000 Family
Out-of-Network:
$9,000/$18,000
Office Visits
In-Network: Tier 1/Tier 2:
PCP: 0% coinsurance after deductible
Specialist: 0% coinsurance after deductible
MH: 0% coinsurance after deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network: Tier 1/Tier 2:
0% coinsurance after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1 and 2 Combined: $6,500 Individual/$13,000 Family
Out-of-Network:
$12,000/$24,000
Prescription Drug Coverage
In-Network:
After Tier 1 Deductible:
Tier 1: 10%
Tier 2: 10%
Tier 3: 10%
Tier 4: 10%
Out-of-Network: Not covered
Monument Health PPO Silver 4000/5500
Deductible Individual / Family
In-Network:
Tier 1: $4,000/$8,000
Tier 2: $5,500/$11,000
Out-of-Network:
$8,000/$16,000
Office Visits
In-Network:
Tier 1: PCP : $35 no deductible
Specialist: $70 no deductible
MH: $35 no deductible
Tier 2: PCP: $50 no deductible
Specialist: $80 after deductible
MH: $50 no deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network:
Tier 1: 40% coinsurance
Tier 2: $500 per stay, then 50% after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1/Tier 2: $7,000/$14,000
Out-of-Network:
$15,000/$30,000
Prescription Drug Coverage
In-Network:
Tier 1: $15
Tier 2: $50
Tier 3: $80
Tier 4: $300
Out-of-Network: Not covered
Monument Health PPO Silver 3500/5000
Deductible Individual / Family
In-Network:
Tier 1: $3,500/$7,000
Tier 2: $5,000/$10,000
Out-of-Network:
$8,000/$16,000
Office Visits
In-Network:
Tier 1: PCP: 1st 3 visits $10, then $35 no deductible
Specialist: $70 no deductible
MH: $10 no deductible
Tier 2: PCP: $50 no deductible
Specialist: $80 after deductible
MH: $50 no deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network:
Tier 1: $750 per day, up to 4 days no deductible
Tier 2: 50% after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1/Tier 2: $8,150 Individual/$16,300 Family
Out-of-Network:
$15,000/$30,000
Prescription Drug Coverage
In-Network:
No Deductible
Tier 1: $15
Tier 2: $50
Tier 3: $80
Tier 4: $300
Out-of-Network: Not covered
Monument Health PPO Gold 1000/2500
Deductible Individual / Family
In-Network:
Tier 1: $1,000/$2,000
Tier 2: $2,500/$5,000
Out-of-Network:
$4,000/$8,000
Office Visits
In-Network:
Tier 1: PCP: $15 no deductible
Specialist: $50 no deductible
MH: $15 no deductible
Tier 2: PCP: $40 no deductible
Specialist: $70 no deductible
MH: $40 no deductible
Out-of-Network:
50% coinsurance after deductible
Inpatient Hospital Stay (after deductible)
In-Network:
Tier 1: 20% coinsurance after deductible
Tier 2: 40% coinsurance after deductible
Out-of-Network:
50% coinsurance after deductible
Out of Pocket Maximum
In-Network:
Tier 1/Tier 2: $6,500 Individual/$13,000 Family
Out-of-Network:
$12,000/$24,000
Prescription Drug Coverage
In-Network:
No Deductible
Tier 1: $15
Tier 2: $50
Tier 3: $80
Tier 4: $200
Out-of-Network: Not covered
1Specialty Drugs may not be available at all pharmacies. Call Customer Service to confirm drug availability.
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