Select Health Monument Value Colorado Option Silver · 55584CO0030006
SelectHealth offers this marketplace health insurance plan (Plan ID 55584CO0030006) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Metal level: SilverPlan type: EPOCSR: Standard Silver On Exchange PlanIssuer: SelectHealth
Telehealth
Data pending
HSA eligible
No
Dental
Not listed
Vision
Not listed
Issuer actuarial value: 70.01%. Expect to pay roughly 29.99% of covered costs out of pocket, based on issuer reporting.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Colorado). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Silver On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Tier
Covered drugs
NON-PREFERRED-GENERIC
2,735
NON-PREFERRED-BRAND
722
ZERO-COST-SHARE-PREVENTIVE-DRUGS
404
SPECIALTY-DRUGS
4
Prior authorization
Drugs
Required
536
Not Required
3,329
Step therapy
Drugs
Required
186
Not Required
3,679
Quantity limits
Drugs
Has Limit
399
No Limit
3,466
Customer highlights
What stands out for members
Issuer: SelectHealth · Plan ID 55584CO0030006 · 2025 filing.
Disease management programs available: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
Variant 55584CO0030006-01 (Standard On Exchange Plan) currently displayed.
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Variant attributes
Select Health Monument Value Colorado Option Silver · Variant 55584CO0030006-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Silver On Exchange Plan
HIOS Product ID
55584CO003
Metal Level
Silver
Plan ID (Standard Component ID with Variant)
55584CO0030006-01
Plan Marketing Name
Select Health Monument Value Colorado Option Silver
Plan Variant Marketing Name
Select Health Monument Value Colorado Option Silver
Issuer & service area
Issuer-provided metadata for this variant.
Issuer Actuarial Value
70.01%
Issuer ID
55584
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
No
Network ID
CON001
Out of Country Coverage
No
Out of Country Coverage Description
All services obtained outisde the service area, except urgent or emergent conditions apply to nonparticipating benefits
Out of Service Area Coverage
No
Out of Service Area Coverage Description
All services obtained outisde the service area, except urgent or emergent conditions apply to nonparticipating benefits
Service Area ID
COS002
State Code
CO
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
AV Calculator Output Number
0.679103987
Medical Drug Deductibles Integrated
Yes
Medical Drug Maximum Out of Pocket Integrated
Yes
SBC Scenario, Having a Baby, Coinsurance
$3,400
SBC Scenario, Having a Baby, Copayment
$10
SBC Scenario, Having a Baby, Deductible
$4,000
SBC Scenario, Having Diabetes, Coinsurance
$0
SBC Scenario, Having Diabetes, Copayment
$300
SBC Scenario, Having Diabetes, Deductible
$900
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$0
SBC Scenario, Treatment of a Simple Fracture, Copayment
$600
SBC Scenario, Treatment of a Simple Fracture, Deductible
$2,100
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family
per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual
Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
40.00%
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family
$9000 per person | $18000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$9,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family
per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual
Not Applicable
Enrollment & documents
Issuer-provided metadata for this variant.
Formulary ID
COF002
SBC Scenario, Having a Baby, Limit
$60
SBC Scenario, Having Diabetes, Limit
$20
SBC Scenario, Treatment of a Simple Fracture, Limit
$0
Additional attributes
Issuer-provided metadata for this variant.
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
No
Design Type
Not Applicable
Disease Management Programs Offered
Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium
99%
First Tier Utilization
100%
Import Date
1/13/2025
HSA Eligible
No
IsItANewPlan
Existing
Notice Required for Pregnancy
No
Is a Referral Required for Specialist?
No
Plan Effective Date
1/1/2025
Plan Expiration Date
12/31/2025
Plan Level Exclusions
Administrative Services/Charges; Certain Allergy Tests; Biofeedback/Neurofeedback; Certain Cancer Therapies; Certain Illegal Activities; Claims After One Year; Complementary/Alternative Medicine; Complications of a Non-Covered Service; Custodial Care; Debarred Providers; Dental Anesthesia where criteria is not met; Duplication of Coverage; Exercise Equipment/Fitness Training; Experimental/Investigational Services (except for approved clinical trials); Refractive Eye Surgery; Food Supplements; Gene Therapy; Hearing Aids; Home Health Aides; Certain Immunizations; Certain Pain Management Services; Certain Prescription/Injectable Drugs and Specialty Medications; Reconstructive, Corrective, and Cosmetic Services; Respite Care; Sexual Dysfunction; Certain Specialty Services; Travel-Related Expenses; computer-assisted interpretation of X-rays; Computer-assisted navigation for orthopedic procedures; Home A1C testing; Magnetic Source Imaging (MSI); Manipulation under anesthesia; Oncofertility; Radiofrequency ablation for lateral epicondylitis; Virtual colonoscopy screening; and certain DME items.
Plan Type
EPO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
55584CO0030006
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family
per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family
$4000 per person | $8000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual
$4,000
TEHBDedOutofNetFamily
per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual
Not Applicable
Unique Plan Design
Yes
Version Number
1
Wellness Program Offered
Yes
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Colorado?
Select Health Monument Value Colorado Option Silver (55584CO0030006) is a Silver EPO from SelectHealth in Colorado for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Select Health Monument Value Colorado Option Silver support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Select Health Monument Value Colorado Option Silver HSA-eligible and does it include dental or vision coverage?
It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.
Dental coverage is not listed for this plan.
Vision coverage is not listed for this plan.
Does Select Health Monument Value Colorado Option Silver support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Which disease management programs come with Select Health Monument Value Colorado Option Silver?
The issuer lists disease management resources for: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
Is there out-of-country coverage for Select Health Monument Value Colorado Option Silver?
No, out-of-country services are not covered for this plan. Details: All services obtained outisde the service area, except urgent or emergent conditions apply to nonparticipating benefits
Does Select Health Monument Value Colorado Option Silver cover care outside the service area?
No, the issuer indicates out-of-service-area care is not covered except for emergencies. Details: All services obtained outisde the service area, except urgent or emergent conditions apply to nonparticipating benefits
How do I enroll in or manage payments for Select Health Monument Value Colorado Option Silver?
Use HealthPorta to shortlist plans, then finish enrollment through Healthcare.gov or your state-based marketplace.
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
