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2022 Rocky Mountain Health Plans DualCare Plus (HMO D-SNP)

2021 Rocky Mountain Health Plan DualCare Plus (HMO D-SNP) H2582-002-000

Medicare

What is a dual special needs plan?

H2582-002-000

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility.

This Health Maintenance Organization (HMO) plan gives you more benefits than Original Medicare, all with as low as a $0 plan premium. You’ll keep all your Medicaid benefits, and add even more.

Archuleta, Delta, Eagle, Garfield, Gunnison, La Plata, Mesa, Moffat, Montezuma, Montrose, Pitkin, Rio Blanco, Routt, and Summit.

Benefits & Features

OTC+Healthy Food

$80 a month on a prepaid card for OTC products and covered groceries at many retailers or online for home delivery. Learn more about this benefit

$0 copay on all covered generic and brand-name prescriptions including home delivery. Learn more about this benefit

Up to $1000 for covered dental such as exams, x-rays, cleanings, fillings, crowns, root canals, and extractions. Learn more about this benefit

$0 copay for 24 one-way rides to or from non-emergency medical doctor visits or to get prescription medications. Learn more about this benefit

$0 copay on yearly routine eye exam and $300 allowance for frames or contacts plus free standard prescription lenses. Learn more about this benefit

Lab services

$0 copay for all lab services

Meal Delivery

Up to 42 meals for 14 days, delivered one time per year after an inpatient hospital stay to maintain nutrition

No referrals required

Access to our large provider network with no referrals needed

Personal emergency response system (PERS)

Personal emergency response device that can get you help quickly, 24 hours a day at no extra cost

Preventive care

$0 copay for preventive care, including annual physical and flu shot

Renew Active® Fitness Program

Renew Active® is a fitness program for body and mind to help stay active, at a gym or from home, at no cost

Routine foot care

Up to 4 foot care visits per year with $0 copay to help keep feet healthy with preventive care

Routine hearing coverage

Routine hearing exam and $2500 allowance toward brand-name hearing aids or UnitedHealthcare Hearing's brand Relate™

Urgent & ER care coverage

Coverage for urgent and emergency care worldwide

Virtual medical visits

$0 copay virtual provider visits to discuss medical concerns, get a diagnosis and treatment for non-emergency conditions

Virtual medical or mental health visits

$0 copay virtual provider visits to discuss non-emergency medical concerns or general mental health conditions from home

Rocky Mountain Health Plans DualCare Plus (HMO D-SNP)

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

Your level of extra help Monthly Premium*
100% $0.00
75% $9.90
50% $19.90
25% $29.80

*This does not include any Medicare Part B premium you may have to pay.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare of TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

Your health care needs are unique. These documents can help you make sure you get the right coverage.

Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary of Benefits, Other downloadable resources.

Downloadable Resources (opens modal window)

Member Resources

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Learn more about dual special needs plans

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Rocky Mountain Health Plans DualCare Plus (HMO D-SNP)