Connect for Health Colorado, PCP, regional organization …the list goes on. Here’s a helpful guide for some of the common terms you hear when it comes to your health coverage.
Colorado PEAK offers an online benefits portal for Coloradans to screen and apply for medical, food, and cash assistance programs. Members can also create an account to help manage their benefits, including updating their contact information, income, and family size. Visit co.gov/peak for more information.Visit Colorado PEAK
Connect for Health Colorado is the State Marketplace for purchasing health insurance. If you lose your Health First Colorado coverage and need health insurance, visit Connect for Health Colorado or call RMHP for help.Visit Connect for Health Colorado
A copay is the amount you pay for a medical service, such as a doctor visit, lab, x-ray, prescription, etc. This is usually a set amount according to your benefit plan.
EPSDT stands for Early Periodic Screening, Diagnosis & Treatment.
This program is for children and teens who are 20 years old and under enrolled in Health First Colorado. When your child or teen is a part of the RAE or RMHP Prime, they are part of the EPSDT program. The EPSDT benefit provides comprehensive and preventive healthcare services for these children. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, developmental, and specialty services.Learn more about EPSDT
RMHP requires providers to meet certain care standards in order to receive incentive payments. These are called KPIs. These can include standards for services like emergency department utilization, hospital re-admissions, high-cost imaging, and well child visits.
Member empowerment is an approach where Members are involved and make decisions with their healthcare providers about their own health. This includes building healthy behaviors and lifestyles and working with providers to choose appropriate procedures and tests. Healthy behaviors and lifestyles play a large role in extending life expectancy and health status. Promoting healthy lifestyles is a core expectation in the ACC where the focus is not only on delivering outstanding care when you are sick, but also on maintaining health.
Your primary care provider (PCP) is your main healthcare provider, or doctor. Your PCP is your medical home, and you should see your PCP each year, even if you are feeling well. Annual checkups are important for good health. Make an appointment with your PCP if you have not had a visit in the past year. When you need care from a specialty doctor, your PCP will help you find the right provider to treat you. Your PCP can also refer you to other services and supports in your community as necessary.
Every Health First Colorado Member belongs to a regional organization. A Member’s regional organization is based on the county where the Member’s primary care provider is. RMHP is the RAE for Health First Colorado Members who live in Western Colorado and Larimer County. As part of the RMHP regional organization, some of your benefits are covered by RMHP, including your behavioral health benefits. RMHP and local community care teams can help connect you to providers near where you live, work with your primary care provider to help you get the medical care you need, and help your providers work with each other and with you to make sure your health care needs are met. RMHP does not make any of your medical decisions; you and your medical providers do.