FAIL result1 Rocky Mountain Plus Plan + Rx (Cost) H0602-019-30 days-Initial Coverage Drugs=S


2015 Rocky Mountain Plus Plan + Rx (Cost) Drug Coverage Details



Below is the Formulary, or drug list, for Rocky Mountain Plus Plan + Rx (Cost) from Rocky Mountain Health Maintenance Organization This formulary is a list of prescription medications that are covered under Rocky Mountain Health Maintenance Organization's 2015 Medicare Advantage Plan. The Rocky Mountain Plus Plan + Rx (Cost) plan has a $0 drug deductible. The Initial Coverage Limit (ICL) for this plan is $2960. The Initial Coverage Period is the period after the Deductible has been met but before the Coverage Gap phase. Once you and your plan provider have spent $2960 on covered drugs. (combined amount plus your deductible) You will enter the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will be required to pay 45% of the plan's cost for covered brand-name prescription drugs unless your plan offers additional coverage. You can see if this plan offers coverage in the "donut hole" be clicking the "Coverage Gap" link on the left above the chart. In 2015 if you have spent $4700 in expenditures you enter the Catastrophic Phase. During the Catastrophic Period you will begin to receive significant coverage. Rocky Mountain Plus Plan + Rx (Cost) will begin paying approximately 95% of your covered medication expenses. You can see if this plan covers your drugs in the Catastrophic Phase by clicking the "Catastrophic" link on the left above the chart.





Plan Name:
Rocky Mountain Plus Plan + Rx (Cost)
Plan ID:
H0602-019
Provider: Rocky Mountain Health Maintenance Organization
Plan Year:2015
Premium:$112.70
Deductible:$0
Initial Coverage Limit:$2960
Coverage Area:Colorado






Current Table info:


Coverage level : Initial Coverage
Days Supply : 30 Days
Drugs Starting With Letter: S



Change Table Options:


Drugs Starting Letter:
A  B  C  D  E  F  G  H  I  J  K  L  M 
N  O  P  Q  R  S  T  U  V  W  X  Y  Z 

Coverage Level:
Initial Coverage
Coverage Gap, Catastrophic

Drug Days Pricing:
30 Day Supply, 60 Day Supply, 90 Day Supply

(Mouse over for Tips)
(Click the Drug Name to Compare every Plans Price)

Drug Name Drug Strength Units in Package Tier Level Amount Limit Days Limit Prior Authorization Y/N Step Therapy Y/N Cost Prefered Max Cost Pref Cost Non Pref Max Cost Non Pref Cost Amt Mail Max Cost Mail



NO COVERAGE FOUND

Please Select a different Coverage Option:
Pre-deductible
Initial Coverage
Coverage Gap
Catastrophic

30 Day Supply
60 Day Supply
90 Day Supply

Call For A licensed Sales Agent

1-855-492-4169

  • Mon-Fri 8:30am-8:00pm


Or Enroll Online Here

Call to Enroll!