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Rocky Mountain Health Plans - RAE

Medicaid

Health First Colorado (Colorado's Medicaid program) is the Medicaid plan for children (newborn to age 18), adults aged 19 to 65 and pregnant Members who live in Colorado and meet income and other requirements. Every Health First Colorado (Colorado's Medicaid Program) Member belongs to a regional accountable entity (RAE), (sometimes called regional organization). 

Rocky Mountain Health Plans (RMHP) ), A UnitedHealthcare Company, is the RAE (Region 1) for Health First Colorado (Colorado's Medicaid Program) Members who have a primary care provider that is located in the following counties: Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Jackson, La Plata, Larimer, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, and Summit. Rocky Mountain Health Plans is the UnitedHealthcare Community Plan for Colorado.

RMHP helps to coordinate your physical and behavioral health care, to include assessments and referrals, access your benefits, make sure you get the help you need - when you need it, work toward health and wellness goals to live healthier lives. RMHP works together with your primary care provider, behavioral health provider, community care teams, and other local partners to help you get the care you need

Benefits & features

Preventive & Wellness Services

Please visit Health First Colorado Benefits and Services webpage for information on Preventive & Wellness Services: https://www.healthfirstcolorado.com/benefits-services or https://www.healthfirstcolorado.com/benefits-services/#preventive-wellness

Mental health care

RMHP covers the following Health First Colorado mental health services: 

  • Behavioral health assessments 
  • Electroconvulsive therapy 
  • Inpatient psychiatric hospital services 
  • Medication management 
  • Outpatient day treatment 
  • Outpatient hospital services 
  • Psychological or neuropsychological testing including administering tests, interpreting results and preparing reports (does not include educational testing, vocational testing or testing for medical conditions) 
  • Psychotherapy: family, individual, individual brief, and group counseling and therapeutic contact 
  • Targeted case management services 

RMHP also works closely with the Community Mental Health Centers in your area. They may also have additional services available, such as: 

  • Vocational services 
  • Intensive case management 
  • Prevention/early intervention activities 
  • Clubhouse and drop-in centers 
  • Residential 
  • Assertive community treatment (ACT) 
  • Recovery services 
  • Respite services 

Some of these behavioral health care services require prior authorization. Your provider will know which services must be approved by RMHP before you can receive them. 

Substance Use Disorder (SUD) treatment

Substance use disorder treatment may be covered by RMHP. Contact RMHP for more details. NOTE: SUD is covered for pregnant women through Special Connections. See Important Community Phone Numbers in the Member handbook to contact Special Connections. Beginning in 2021, additional SUD benefits are covered. Members now have additional coverage (4 levels of care) including inpatient withdrawal management and residential treatment. 

  • Medically Managed Withdrawal Management (WM) Services — Level 3.7 WM 
  • Medically Monitored Intensive Inpatient Services — Level 3.7 
  • Clinically Managed High Intensity Residential Services — Level 3.5 
  • Clinically Managed Population-Specific High Intensity Residential Services — Level 3.3 
  • Clinically Managed Low Intensity Residential Services — Level 3.1 
  • For Inpatient withdrawal management: 
  • Level 3.7 WM is considered a behavioral health benefit 
  • Level 4 WM is considered a physical health benefit 

SUD Treatment and services is managed by RMHP Behavioral Health Utilization Team. Prior authorization for treatment and services may be required. Please talk to your provider about contacting RMHP before you receive SUD services.  

After all Medicaid appeals processes have been exhausted, Members/Providers may request an external medical review when there is a denial or reduction for residential or inpatient substance use disorder treatment.

We can help you find out how and where to get these services in your area. If you’re struggling or someone you love is hurting and you need to get help right away, contact Colorado Crisis Services. Coloradans can get free, confidential, and immediate help 24 hours a day, 7 days a week, 365 days a year from Colorado Crisis Services. Contact Colorado Crisis Services by calling 844-493-TALK (8255) or text TALK to 38255. You can also get online support at ColoradoCrisisServices.org.

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

Please visit Health First Colorado Benefits and Services webpage for information on Maternity and Newborn care: https://www.healthfirstcolorado.com/benefits-services/ or https://www.healthfirstcolorado.com/benefits-services/#maternity-newborn

RMHP offers programs for pregnancy care as well. WellHop & SimpliFed are programs to provide support for expectant moms during their pregnancy and beyond.

Care Coordination is a way that RMHP helps Members coordinate services for serious illnesses or injuries or helps to provide individualized support for complex or special needs. Care coordination may also be referred to as Care management or case management. Sometimes your doctor or hospital may tell RMHP that an RMHP Member needs a Care Coordinator. Care Coordinators also check to see if other services may work for you. This helps to make sure you are getting care that is medically necessary. You can also call and ask us for help.

Here is how to reach us:

Member Services at 1-800-421-6204 and ask to speak to a Care Coordinator.

If you need language assistance you can call us. If you are Deaf, hard of hearing, or have a speech disability, dial 711 for Relay Colorado or use our Live chat on uhccp.com/CO or member secure website at myuhc.com/communityplan. Care Coordination staff are available Monday through Friday, 8:00 a.m. to 5:00 p.m. After hours you can leave a message and we will call you back the next business day.

Through DentaQuest; Learn more about Adult Dental Benefits and DentaQuest (https://hcpf.colorado.gov/dental-benefits) Contact DentaQuest to find out more: 1-855-225-1729, TTY: 711 DentaQuest.com/Colorado

Dental Services through DentaQuest include: Services include cleanings, fillings, root canals, crowns, and partial dentures. There are no co-pays applicable. Limit: Annual adult (21 years old and up) benefit of up to $1,500 per state fiscal year which runs from July 1 – June 30. Emergency and dentures benefits are not subject to this limit. There is no limit for children’s services (21 years old and under). There are no exclusions. Sometimes a prior authorization is needed, check https://www.healthfirstcolorado.com/glossary/prior-authorization-request-need-one/ to determine if a prior authorization is needed.

Have questions? Visit myuhc.com email us at rrmhp_member_services@uhc.com, or call Member Services at 1-800-421-6204, TTY 711, 8 am – 5 pm, MST, Monday - Friday. 

Please understand that any email you send to us outside of the myUHC portal may have your protected health information in it. That email will be sent unencrypted. When an email is sent unencrypted there might be a risk that someone else could read it. The contents of the unencrypted email could be disclosed.

We have a RMHP RAE Provider Directory that lists doctors in your county. Look for a doctor that you want to see when you are healthy and when you are sick. This doctor may be a physician with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics or obstetrics and gynecology. If you do not know the doctors on the list, pick a doctor with an office close to your home. If you pick a doctor you have not seen before, call the doctor's office. Ask the office if they will take you as a new patient. If they will take you as a patient, tell them you are picking the doctor as your PCP. If you have not seen a doctor in the past year, make an appointment. Keep your scheduled appointment, or let the doctor's office know you need to reschedule.

Member Services at 1-800-421-6204, TTY 711 if you need help finding a PCP or if you need a Provider Directory. Each person in your family can have a different PCP. Health First Colorado Enrollment can also help you choose or change your primary care provider (PCP). They can also help you find providers that meet your needs. Go to Enroll.HealthFirstColorado.com. Or call 1-303-839-2120 or 1-888-367-6557 (State Relay 711). Call Monday to Friday, 8 a.m. to 5 p.m. The call is free.

Individuals with Special Needs

Home-and Community-Based Services (HCBS)

Home-and Community-Based Services help you and your family in your home. You may qualify for home health care and non-skilled home help. You can ask your doctor or an RMHP Care Coordinator for help setting up this service.

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 received before you joined RMHP.
  • Keep seeing your other doctors for 75 calendar days. You can keep getting the same care you received 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.

If you have a question, need help with your health care, or have a special need, please contact us.

We’re here to help. Call Member Services at 1-800-421-6204. Representatives are available Monday–Friday, 8:00 a.m.–5:00 p.m. If you are deaf, hard of hearing, or have a speech disability, dial 711 for Relay Colorado or use our Live Chat on uhccp.com/CO or myuhc.com/communityplan.

Language Help

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 800-421-6204 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 800-421-6204 o State Retransmisión 711 para personas con discapacidad auditiva o del habla.

Nurse Hotline

Health First Colorado Nurse Advice Line:

The Health First Colorado Nurse Advice Line gives you free medical information and advice 24 hours a day, every day of the year. Call 800-283-3221 (State Relay 711) to:

  • Talk to a nurse who will answer medical questions, give care advice, and help you decide if you should see a provider right away.
  • Get help with medical conditions such as diabetes or asthma, including advice about what kind of provider may be right for your medical condition.

The Nurse Advice Line cannot help with clinic appointments or medication refills. Call your provider's office if you need help with these.

Phone Services

Colorado Lifeline Service is a government assisted wireless service that provides discounted home phone or cell phone services to eligible low income families and individuals. Colorado Lifeline Service discounts are offered to qualified Colorado customers who meet certain eligibility requirements such as, government assistance or a household income that is at or below 135% of the federal poverty level. Customers can check their Eligibility for the Program, apply online and avail the benefits, along with Discounts and Offers.

Select the prepaid plan that best fits your needs. There are several prepaid plans available under TAG Mobile Colorado Lifeline Services. You can change your plan every month to fit your lifestyle or you can add minutes anytime at your convenience.

Free Lifeline Government Cell Phone Service in Colorado (tagmobile.com)

Quit using Tobacco or Vaping Products

<p>Free QuitLine tobacco cessation counselor — Call 800-QUIT-NOW (800-784-8669) or visit www.coquitline.org

Member resources

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Learn more about Rocky Mountain Health Plans RAE