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UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) in 2025, please refer to our full plan details page.
This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for the 2025 plan year to people living in Select Counties in Colorado. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
Health deductible: information not available.
This plan has a $420.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $5900.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan has an enhanced alternative drug benefit. The plan has a $420 deductible. After the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy you use. For example, in the initial coverage phase, you'll pay $8 for a preferred generic at a standard pharmacy, $47 for a standard generic, and $100 for a preferred brand. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, but many outpatient services, like primary care and preventive services, have no copay. The plan also covers services like ambulance, emergency care, vision, and dental, with specific copays and coinsurance amounts. Additionally, there are benefits for home health, medical equipment, and other services, each with its own cost structure that you should review to understand your financial responsibility.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-7, and no copay for days 8-90, while for Inpatient Hospital Psychiatric you will pay a $350 copay for days 1-6, and no copay for days 7-90.
Outpatient Services See details
Outpatient Services include Outpatient Hospital Services with a copay of $0.00 - $350.00, Observation Services with a $350.00 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with copays ranging from $0.00 to $25.00 for individual sessions and $15.00 for group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, each with a $290 copay and no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan. Emergency Services have a $125 copay and no coinsurance, Urgently Needed Services have a copay between $0-$55 with no coinsurance, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay, while Chiropractic Services require a $20 copay. Occupational Therapy Services are covered with a copay between $0 and $45, and Physician Specialist Services have a copay between $0 and $45. Mental Health Specialty Services and Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Podiatry Services have a $45 copay, and Other Health Care Professional services have a copay between $0 and $45. Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $45, and Additional Telehealth Benefits have no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, while other services such as Health Education, In-Home Safety Assessment, and others are not covered. Additional preventive services like Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas are covered with no copay.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one per year. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan covers vision services, including routine eye exams and eyewear. Eye exams have no copay, while eyewear has a combined maximum benefit of $250 every two years, with no copay for contact lenses, eyeglass frames, and eyeglass lenses (copay between $0 and $153).
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan, but prior authorization is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by this plan. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay; Diagnostic Radiological Services have a copay of at most $250, and Outpatient X-Ray Services have a $25 copay. Therapeutic Radiological Services have 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services offered by UHC Rocky Mountain Medicare Advantage CO-004P (HMO-POS) include Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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