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Rocky Mountain Health Plans (RMHP) - Child Health Plan Plus (CHP+)
Through the Child Health Plan Plus (CHP+) program, Rocky Mountain Health Plans (RMHP) provides low-cost health insurance benefits to children and pregnant women 19 and older who do not qualify for Health First Colorado but do not earn enough to pay for private health insurance.
Rocky Mountain Health Plans (RMHP) - Child Health Plan Plus (CHP+)
- Colorado children age 18 and under and pregnant women.
- Individuals with a household income less than about $30,000 a year, or a family of four that makes less than about $63,000. If your household earns more, you may still qualify.
- Lawfully residing children and pregnant women.
- Children and pregnant women who do not have other health insurance or qualify for Health First Colorado (Colorado's Medicaid Program).
This RMHP CHP+ plan is available in the following counties:
Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hindsdale, Jackson, La Plata, Lake, Mesa, Moffat, Montezuma, Montrose, Pitkin, Ouray, Rio Blanco, Routt, San Juan, San Miguel, and Summit
To see if you qualify, you can:
- Apply Online: It's the fastest way to find out if you qualify! Apply online by visiting CO.gov/PEAK.
- Apply by Phone: Call CHP+ Customer Service at 1-800-359-1991 / State Relay: 711
- Apply In Person: Apply at your County Department of Human or Social Services Office or an application assistance site. Find a location near you at CO.gov/HCPF/CHPPlus.
- Apply by Mail: Fill out a paper application. You can mail it in or drop it off at your local County Human or Social Services Office or an application assistance site.
For more information:
Find providers and coverage for this plan.
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Find medications covered by this plan.
Find a pharmacy near you.
Find a dentist near you.
Benefits & Features
Asthma and COPD Support
Respiratory therapies are covered as ancillary services in an inpatient facility as well as in an outpatient setting. See Member Handbook for more details.
Choice of Doctor
If you want to change your PCP, go to the secure member website (myuhc.com/communityplan) and follow the steps for picking a new PCP. You can change your PCP at any time. Information in the provider directory includes the names, titles, addresses and telephone numbers of providers that are in RMHP’s network. This means you can see these providers without contacting RMHP first.
If you need a provider directory or need help finding a PCP in your area, call Member Services. RMHP’s online provider directory can be found at uhccp.com/CO or by logging into your secure member website at myuhc.com/communityplan. This directory gives you information about contracted providers in your area who speak languages other than English, and which providers accept new patients.
If you are changing doctors because you moved, call CHP+ Eligibility and Enrollment Broker, 1-888-367-6557 to let them know your address has changed. You can also update your address in your PEAK account. Call Member Services if you need help changing your PCP..
With a diagnosis of diabetes, we offer support with: inpatient nutrition counseling, outpatient nutrition and self-management training and follow-up visits for members diagnosed as diabetic.
Emergency Transport/Ambulance Services
Coverage for a life or limb-threatening emergency if transported in a licensed ambulance. See Member Handbook for more detail and exclusions.
Equipment and Medical Supplies
Durable Medical Equipment-Maximum of $2,000 per calendar year. See Member Handbook for further details for this benefit.
Home Health Care/Home Infusion Therapy
Who can provide home health care/home infusion therapy?
Benefits are provided for services performed by a home health agency that can arrange and provide nursing services, home health aide services and other therapeutic services. Home infusion therapy is when a nurse comes to your home to give you a medication intravenously (through an IV) or with a shot. Please see Member Handbook for additional covered services.
Medically Necessary Covered Services for patients that are generally and typically provided by acute care general Hospitals. Hospital Services shall also include services rendered in the emergency room and/or the outpatient department of any Hospital. Except for a Medical Emergency or Written Referral, Hospital Services are Covered Services only when completed by Participating Providers. Please see Member Handbook for other details.
Individuals with Special Health Care Needs
If you are new to RMHP and you have special health care needs and are seeing a doctor that is not on our list, you can:
- Keep seeing your previous primary care doctor for 60 calendar days. You can keep getting the same ongoing care you got before you joined RMHP.
- Keep seeing your other doctors for 75 calendar days. You can keep getting the same care you got before you joined RMHP.
- Keep seeing your previous primary care doctor if you are in your fourth through ninth month of pregnancy. You can keep seeing your previous primary care doctor until you finish the care you need following the birth of your child.
Having special health care needs can be frightening and difficult, but RMHP is here to help you. We want you to follow your doctor’s treatment plan and learn about your special needs. Our nurses and Care Coordinators will work with you one-on-one.
Kidney Disease Care
Kidney Dialysis is covered with $0 copay.
Lab & X-rays
Benefits are provided for diagnostic services received in a provider’s office when they are required to diagnose or monitor a symptom, disease or condition. Benefits for diagnostic services done in a provider’s office include, but are not limited to, the following:
- X-ray and other radiology services,
- Laboratory and pathology services, and
- Ultrasound services for non-pregnancy related conditions.
For pregnancy-related ultrasounds, see the Maternity and newborn child-care section of the Member Handbook.
If you need help with the information in any RMHP document, including written/ oral translation; or in a different format like large print or as an audio file, we can help you at no cost. You can get help by calling Rocky Mountain Health Plans (RMHP) at 877-668-5947 or State Relay 711 for callers with speech or hearing disabilities.
Si necesita ayuda con la información en cualquier documento de RMHP incluida la traducción oral/escrita, un formato diferente (como letra grande), o un archivo de audio, podemos ayudarlo sin costo. Puede obtener ayuda llamando Rocky Mountain Health Plans (RMHP) al 877-668-5947 o State Retransmisión 711 para personas con discapacidad auditiva o del habla.
Lead Screening in Children
Covered as part of wellness checkups with your Primary Care Provider.
The most up-to-date list of prescription medications covered under this plan is on RMHP’s website at uhccp.com/CO. A paper copy is available at no cost by calling Member Services. The name of the document that lists covered prescription medications for this plan is RMHP PRIME and CHP+ formulary. The RMHP PRIME and CHP+ formulary also provides information about coverage guidelines, quantity limits, which medications that require pre-authorization, and what to do if you are prescribed a medication that is not on the list.
This plan covers up to a 90-day supply of a prescription maintenance medications from an in-network pharmacy. Some medications are limited to 30-day supplies at one time. Mail order fills up to a 90-day supply. Prescription contraceptives, including oral contraceptives (the Pill), contraceptive patches, and vaginal ring contraceptives, can be covered for up to a 12 month (1 year) supply after filling 3 months of the same contraceptive. Please see Member Handbook for more information.
Shots and Vaccines
Covered as part of regularly scheduled childhood and adult preventive services.
Coverage for outpatient physical rehabilitation (physical, occupational, and/or speech therapy) includes up to 30 visits per calendar year per diagnosis.
For children ages 0-3, additional therapies as described above, are unlimited for those members who qualify for Early Intervention Services.
Rocky Mountain Health Plans CHP+
We want to make it as easy as possible for you to get the most from your health plan. As our member, we provide member communication and materials to inform and educate you on your plan’s benefits and the resources available.
You can download from the options below or call Member Services at 1-877-668-5947 to request a copy (in large print, other format, or other language) be mailed to you within 5 business days, at no cost.
Clinical Practice Guidelines
These Clinical Practice Guidelines (“Guidelines”) are not meant to replace the clinical judgment of a Member’s physician or other professional health care provider (collectively, “Providers”). As such, these Guidelines do not establish a standard of care or practice or replace appropriate clinical decision-making. These Guidelines must always be used in the context of a health care Provider's clinical judgment in the care of a particular patient.
For that reason, Guidelines may be viewed as an educational tool to provide information and assist Members and Providers in choosing appropriate health care for specific clinical conditions and diagnoses. Deviations from the Guidelines may be necessary and appropriate in certain individual circumstances.
Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage documents or contact RMHP Member Services at 1-877-668-5947 to determine what health care services are covered benefits and if other conditions or limits of coverage apply.
For more information around clinical guidelines, please visit: Clinical Practice Guidelines for RMHP
The Family Healthline is a statewide telephone information and referral service (English and Spanish) that provides callers with the eligibility criteria and resources for Colorado health care programs that provide services to pregnant women, children and individuals. Resources include indigent medical care, vision, dental, mental health care programs and nutrition programs. Information is also available about services for emergency shelters, domestic violence counseling, victim assistance programs, legal aid, housing assistance, abstinence education, family planning and other services as needed. Call 1-800-688-7777 for more information.
How to Contact Us
Para Asistencia en espanol, llame al 877-668-5947. Espanol representates de Servicio al Cliente estan disponibles. Tenemos este libro en espanol.
Tell us if you need interpreter services or help in other languages or format. There is no cost for these services.
An advance directive is a type of written instruction about the health care to be followed if you become unable to make decisions about medical treatment. You prepare your Advance Directive when you are able to make these decisions. Then, if there is a time when you are unable to make health treatment decisions, the directive will be followed. These instructions do not take away your right to decide what you want, if you are able to do so at the time a decision is needed.
How to Disenroll
It is your choice to have RMHP CHP+. During the first 90-days of your enrollment or at your annual renewal, you have the option to change MCO's if you live in a county where more than one MCO is offering a CHP+ plan.
You can disenroll from Colorado's Child Health Plan Plus (CHP+) program at any time for any reason. You will need to contact the county or organization that processed your CHP+ application and tell them that you want to disenroll. If you get other insurance, become covered by Health First Colorado, or move out of Colorado, you are no longer eligible for CHP+.
RMHP Organizational Documents
It's important for us to ensure our Members, partners, and stakeholders have the information needed to learn about our Regional Accountable Entity initiative. Please, please find the relevant reports and resources.
- Governance Plan
- Annual Quality Report
- Annual Quality Improvement Plan
- Population Management Strategic Plan
- Annual Network Management Strategic Plan (Includes Practice Support Plan and Administrative Payment Report)
- Quarterly Network Report
- Regional Program Improvement Advisory Council Materials/Minutes
- Member Advisory Council Materials/Minutes
CirrusMD for RMHP
CirrusMD provides the fastest connection to a board-certified doctor - answers to your healthcare questions are a text message away. Securely text, send photos, or video chat with a provider in the app right from your smartphone or computer. CirrusMD is available 24/7 for our Regional Organization (RAE), PRIME, CHP+ and DSNP Members at no cost.
Learn more about CirrusMD for RMHP
What Can CirrusMD Help With?
- General Health Questions: Do you have questions about medication side effects, lab orders/results, recommended health screens, or follow up questions after recent in-person care?
- Questions About Where to Receive Care: Before you schedule an in-person appointment or go to the ER, chat with a doctor instantly on CirrusMD.
- Urgent Care: coughs, fevers, sore throat, stomach pain, rashes, allergic reactions, animal/insect bites, and pediatric care such as common viral infections
- Mental Health: anxiety, depression, stress, insomnia
- Chronic Care and Prevention: Is your asthma under good control? Questions about weight loss, smoking cessation, managing diabetes, hypertension, or acne?
- Women’s Health: birth control, irregular bleeding, urinary tract infections, wellness
Notice of Privacy Practices
RMHP is committed to protecting the confidentiality of your medical information to the fullest extent of the law. In addition to the laws that govern your privacy, RMHP has its own privacy policies and procedures to help protect your information. If you would like a copy of RMHP’s privacy policies and notices, visit https://www.uhccommunityplan.com/privacy-policy, refer to Notice of Privacy Practices in the Member handbook, or call Member Services.
Member Rights and Responsibilities
As a Member, you have the right
- To get information about RMHP and its services, doctors, and health care providers and to get information about your rights and responsibilities
- To be treated with respect and with recognition of your dignity and right of privacy
- To accept or refuse medical treatment to the extent provided by Colorado state law and to participate in making decisions about your health care
- To have open discussions with health care providers about appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage, and presented in a manner appropriate to your condition and ability to understand
- To make appeals, and to bring complaints to RMHP or the Department of Health Care Policy and Financing
- To be furnished with health care services in accordance with federal health care regulations for access and availability, care coordination and quality
- To expect all communications regarding your care to be kept confidential as required by law
- To freely exercise your rights without being treated differently
- To be free from the use of physical restraint or being isolated. These methods may not be used to make you cooperate, to punish you, for the ease of the caregiver, or as a way of getting back at you.
- To get family planning services from any enrolled provider that serves CHP+ members in or out of RMHP’s network, with no referral
- To request and receive your medical records and to have them changed according to federal law
- To get a second opinion with no referral
- To be free from discrimination based on race, color, national origin, age, disability, sex, sexual orientation, or gender identity
- To make recommendations regarding RMHP’s rights and responsibilities policy
- To use any hospital or other setting for emergency care
As a Member you have the responsibility
- To choose a Primary Care Physician (PCP) for each member of your family and to let that PCP know of any Advance Directive regarding your medical care
- To let your PCP direct your care with specialists and other health care providers, except in cases of medical emergencies, urgent care when outside the service area, obstetrical or gynecological care, and eye care
- To learn about your RMHP health care benefits, procedures, and limitations and to be cooperative and considerate with health care providers and staff
- To notify Member Services of membership or address changes, marriage, birth of a child, or adoption of a child
- To take responsibility for copayments and costs for certain health care services and any services that are not covered by CHP+
- To provide the health care provider with all information needed for you to receive appropriate care and to follow the care and instructions agreed upon with your provider
- To follow the plans and instructions for care that you and your provider agreed on
- To tell your providers about any Advance Directives about your health care if you choose to do this
- To follow any protocols of a responsible third-party payor (such as other insurance) prior to receiving any non-emergency services
- To provide RMHP with written notice after filing a claim or action against a third party responsible for your illness or injury
- To understand your health problems and participate in making treatment goals
- To tell RMHP about any other insurance you may have, including Medicare
- To file a complaint or grievance, please follow the rules as described in the Appeal and grievance section of the Member handbook
Filing a Grievance or Appeal
You have many rights as an RMHP Colorado CHP+ member. You have the right to complain about RMHP. You have the right to complain about your care. You, your provider or a Designated Client Representative may complain about anything you are unhappy about or have a problem with. To get more information about appeals and grievances refer to your Member Handbook or call Member Services.
If you need help with the information in this document, including written/oral translation; or in a different format like large print or as an audio file, we can help you at no cost. You can get help by calling Rocky Mountain Health Plans (RMHP) at 877-668-5947 or State Relay 711 for callers with speech or hearing disabilities.
Pharmacy Reimbursement Form
Release of information form
This form is used to give another person permission to receive or give information about you and your health.
Revocation of release form
This form takes away permission for someone to receive or give information about you and your health.
Rocky Mountain Health Plans - Child Health Plan Plus (CHP+)