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Rocky Mountain Health Plans - PRIME - Frequently Asked Questions
What is Medicaid?
Medicaid is a program for people with low income who meet certain eligibility requirements and programs can vary from state-to-state.
How do I contact Customer Service/Member Services?
What is an advanced directive?
An advance directive is written instruction for the health care and medical treatment you want if you become unable to make those decisions when they are needed. It is written when you are able to make these decisions and before care is needed. Then, if there is a time when you are unable to make decisions about your medical treatment, the instructions will be followed. Even if you have an advance directive, you still have the right to decide what treatment you want at the time care is needed, if you are able to do so.
For more information, please visit: https://www.rmhp.org/blog/2019/may/advance-directives
Which services require preauthorization?
When you see a participating provider, your doctor obtains the necessary prior authorization for you. For services provided by a non-participating provider, it is your responsibility to start the prior authorization process. If you do not receive prior authorization for your care, you will not receive your maximum benefits as stated in your Member materials.
For more information, please visit: https://www.rmhp.org/learning-center/about-your-coverage/understanding-prior-authorization
What is urgent care?
Urgent care is not emergency care. It is care that you need sooner than a normal appointment (within 24 hours). You might need this for things like sprains, mild-to-moderate bleeding, bruises, minor burns, drug reactions or an illness lasting longer than a day. Seek urgent care from a provider in the network. If you require urgently needed care when you are in an area outside of your network, then you may get this care from any provider.
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