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Managed Care Organizations

Managed care organizations are groups of doctors, clinics, hospitals, pharmacies and other providers who work together to take care of their members' health care needs. Another name for a managed care organization is a network or a health plan.

 

Managed care members must choose a primary care physician (PCP). Whenever there is a medical problem, the managed care member must first talk to their PCP. The PCP can treat or refer members to a specialist within the network. Members cannot see providers outside the network except in emergencies or with a PCP referral.

 

The advantages of a managed care health plans are:

  • Coordination from an entire health care system

  • Preventive care examinations for adults and 24 hour access to medical care

  • No co-payments (except for Rocky Mountain Health Plan)

  • Access to a broad provider network

     

There are two managed care organizations in Colorado.

A Plan Comparison Chart shows the differences between the health plans.

 

There is also information in each plan's Member Handbook:

For more complete information about a plan call HealthColorado or the health plan. 

  • The HealthColorado customer service number is (303) 839-2120 (Denver Metro Area) or 1-888-367-6557 toll free.  TTY is 1-800-659-2656.  You can call Monday to Friday, 8 a.m. to 5 p.m.

  • The Denver Health Medicaid Choice Plan customer service number is (303) 602-2116 (Denver Metro Area) or 1-800-700-8140 toll free.

  • The Rocky Mountain Health Plan customer service number is (970) 243-7050 or 1-800-221-3943 toll free.