2017 Medicare Advantage Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | Rocky Mountain Basic Plan (Cost) | ||||
Location: | Bent, Colorado Click to see other locations | ||||
Plan ID: | H0602 - 026 - 0 Click to see other plans | ||||
Member Services: | 1-888-282-1420 TTY users 711 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
||||
Email a copy of the Rocky Mountain Basic Plan (Cost) benefit details
![]() | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $10.00 (see Plan Premium Details below) | ||||
Annual Deductible: | no drug coverage | ||||
Health Plan Type: | Cost * | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $0 | ||||
Number of Members enrolled in this plan in Bent, Colorado: | less than 10 members | ||||
Number of Members enrolled in this plan in Colorado: | 1,204 members | ||||
Number of Members enrolled in this plan in (H0602 - 026): | 1,363 members | ||||
Plan’s Summary Star Rating: | 3.5 out of 5 Stars. | ||||
• Customer Service Rating: | Insufficient data to rate this plan. | ||||
• Member Experience Rating: | 3 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. | ||||
— Plan Premium Details — | |||||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | 100% Subsidy | 75% Subsidy | 50% Subsidy | 25% Subsidy | |
Monthly Part D Premium with LIS: | $0.00 | $0.00 | $0.00 | $0.00 | |
— Plan Health Benefits — | |||||
** General Plan Information ** | |||||
Choice of Doctors?: Plan Doctors for Most Services | |||||
** Cost ** | |||||
Monthly Health Plan Premium: $10.00 | |||||
Monthly Drug Plan Premium: Not Applicable | |||||
Health Plan Deductible: Coming soon | |||||
Other Health Plan Deductibles?: No | |||||
Maximum Out-of-Pocket Enrollee Responsibility (does not include prescription drugs) : Not Applicable | |||||
** Extra Benefits ** | |||||
Prescription Drugs Covered?: No | |||||
Optional Supplemental Benefits?: No | |||||
** Outpatient Care and Services ** | |||||
Ambulance: 20% | |||||
Doctor's office visits:
| |||||
Durable medical equipment (wheelchairs, oxygen, etc.): 20% per item | |||||
Emergency care: 20% per visit (always covered) | |||||
Home health care: You pay nothing | |||||
Mental health care: Coming soon | |||||
Outpatient hospital: 20% per visit | |||||
Renal dialysis: 20% per visit | |||||
** Inpatient Care ** | |||||
Inpatient hospital care: Coming soon | |||||
Optional Supplemental Benefits?: No | |||||
Skilled Nursing Facility (SNF): Coming soon | |||||
Prescription Drugs Covered?: No | |||||
** Additional Benefits ** | |||||
Optional Supplemental Benefits?: No |