2015 Rocky Mountain Plus Plan (Cost) H0602-003 By Rocky Mountain Health Plans

Rocky Mountain Plus Plan (Cost) By Rocky Mountain Health Plans



Rocky Mountain Plus Plan (Cost) is a 2015 Medicare Advantage ("Part C" or "MA Plan") plan by Rocky Mountain Health Plans. This plan from Rocky Mountain Health Plans works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for Rocky Mountain Plus Plan (Cost) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Rocky Mountain Health Plans and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.



2015 Medicare Advantage Plan Details

Plan Name:
Rocky Mountain Plus Plan (Cost)
Plan ID:
H0602-003
Provider: Rocky Mountain Health Plans
Plan Year:2015
Plan Type: Cost *
Monthly Premium C+D: $168.00
MOOP: $4,500


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Coverage Area for Rocky Mountain Plus Plan (Cost)

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The Rocky Mountain Plus Plan (Cost) H0602-003 is available to residents in Colorado, and has a in-network Maximum Out-of-Pocket limit of $4,500 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in Rocky Mountain Plus Plan (Cost) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $4,500 This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.

Rocky Mountain Plus Plan (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.





Ratings for Rocky Mountain Plus Plan (Cost) H0602

2015 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing


Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints and Changes in Rocky Mountain Plus Plan (Cost) Plans Performance

Total Rating
Members Leaving the Plan
Complaints about Health Plan
Health Plan Quality Improvement


Health Plan Customer Service Rating for Rocky Mountain Plus Plan (Cost)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancel Screening
Cardiovascular Screening
Diabetes Care
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment


Ratings For Managing Chronic And Long Term Care

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Diabetes Care - Cholesterol
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions


Ratings For Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
High Risk Medication
Diabetes Treatment
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)


Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


Rocky Mountain Plus Plan (Cost) Drug Plan Customer Service ratings

Total Rating
Appeals Auto Forward
Appeals Upheld


Source: CMS.
Plans as of September 2, 2014.

Star Rating as of Oct 3, 2014.

For More Information on Ratings Please See the CMS Tech Notes Here.

Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit

Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.


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