Is Unitedhealthcare Dual Complete A Medicare Plan

Unitedhealthcare Dual Complete Choice

UnitedHealthcare Dual Complete Choice H1889-002-001 is a 2021 Medicare Advantage Dual-Eligible Special Needs Plan provided by UnitedHealthcare.

A Special Needs Plan is a type of Medicare Advantage Plan designed for Medicare beneficiaries with specific conditions or characteristics.

Special Needs plans provide both health coverage and drug coverage, and each coverage type has different costs to consider.

This plan has a monthly premium of $30.80, which covers both the health and drug portions of the plan.

When it comes to out-of-pocket costs for drugs, this plan has a Part D drug Deductible of $445.00 and an Initial Coverage Limit of $4130. Each drug tier may be subject to different cost-sharing in each coverage phase, so keep that in mind when considering out-of-pocket costs. Check out the drug formulary below for more information, or reach out to a licensed Medicare agent for help using the call number on this page. Alternatively, if you know what plan you want, you can enroll online yourself using our site as well.

Plan Basics

Insurance Carriers We Accept

This is not a comprehensive list. Please contact us at 404.255.5956 or 1.843.571.4840 to confirm your insurance carriers participation.

Aetna

Open Access , HMO, HMO OA, Choice POS, Open Choice PPO, Elect Choice EPO/OA, Managed Choice OA/POS, Select, Whole Health, Premier Care Network, NAP

Aetna Medicare Advantage

Supplement plans only

BCBS

Federal Employee Program, HMO, POS, PPO, Indemnity, Anthem, Pathway, Exchange

BCBS Medicare Advantage

PPO, Open Access Plus, Choice Fund OA Plus, NALC

Commercial

Patient to verify through insurance company using Facility Tax ID # 571099718

Coventry

Commercial Plans , First Health Plans, GEHA by Coventry Health Care of GA

Coventry Advantra

Coventry Health Care Medicare Advantage Plan

Humana

National POS OA, choice PPO, Choice Regional PPO, HMO Premier OA

Kaiser Insurance

Traditional Medicare primary or secondary policies

Tricare

Tricare for Life Standard Fee for Service

United Healthcare

Choice, Choice Plus, Choice Plus HSA, Heritage Plus

UHC Medicare Advance

Group Medicare Advantage PPO, Care Improvement Plus Medicare Advantage Regional PPO

UHC and AARP see below for all providers.

Commercial

• AARP MedicareComplete Plan 1
• AARP MedicareComplete Plan 2
• AARP MedicareComplete Plan 3
• AARP MedicareComplete
• Care Improvement Plus Gold RX
• Care Improvement Plus Medicare Advantage
• Care Improvement Plus Silver RX
• Care Improvement Plus Gold RX

Please to view our Financial Policy

How We Reviewed Medicare Providers

Even Medicare health plans with a national presence can vary locally in their cost, quality, and customer satisfaction. To evaluate Medicare plans, we looked at health insurance industry ratings from the primary accrediting agency for health plans, NCQA, and the Medicare Star Ratings from CMS, the regulatory agency that oversees Medicare. We included the National Association of Insurance Commissioners complaint index and AM Bests financial stability ratings. We also considered information from the companies on their programs and strategies.

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Need More Information We Can Help

You can find complete information about dual plans available your area at UHCCommunityPlan.com Or call , TTY 711 from 8 am 8 pm local time, seven days a week. See if a dual plan is right for you.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare and a contract with the State Medicaid Program.

This information is not a complete description of benefits. Call , TTY 711 from 8 am 8 pm local time, seven days a week for more information.

Search For A Network Pharmacy Below

You may also go to OptumRx to order and manage your prescription drugs online.

Learn more about dual special needs plans

Search and select covered providers

Available in English or Spanish

Email confirmation with next steps when complete

Please have your Medicaid and Medicare information ready

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American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Pharmacy Direct Member Reimbursement Form

• PDF 188.69KB – Last Updated: 11/12/2020

Prescription Drug Transition Process

What to do if your current prescription drugs are not on the Drug List or are restricted in some way

New members

As a new plan member, you may currently be taking drugs that are not on the plans formulary , or they are on the formulary but are restricted in some way.

In instances like these, start by talking with your doctor about appropriate alternative medications available on the formulary. If no appropriate alternatives can be found, you or your doctor can request a formulary exception. If the exception is approved, you may be able to obtain the drug for a specified period of time. While you and your doctor are determining your course of action, you may be eligible to receive a transition supply of at least a 1-month supply as described in your plans Evidence of Coverage of most drugs anytime during the first 90 days of membership in the plan. If the prescription is written for fewer days, multiple fills are allowed during the first 90 days until youve received at least a 1-month supply of your drug as described in your plans Evidence of Coverage. After your transition supply, these drugs may not continue to be covered.

If you live in a long-term care facility, but you are past the first 90 days ofmembership in our plan, the transition program may cover at least a 31-day emergency supply ofmost drugs while you pursue a formularyexception.

Continuing members

Related Information

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Unitedhealthcares 2022 Medicare Plans Shaped By Consumer Expectations For Value Choice And Experience

• 90% of eligible consumers to have access to pharmacy benefits with $0 tier 1 retail copays nearly 80% to have access to a plan with no Rx deductible

  98% of members will have stable or improved benefits in 2022 and most will see stable or reduced Medicare Advantage premiums, including nearly 3 million members with $0 premiums

  Expanding access to the nations largest Medicare Advantage provider network to connect more people to quality, supported care when and where they need it

  Increasing access to $0 Rx retail copays and healthy food benefit for D-SNP members

UnitedHealthcares 2022 Medicare Plans Shaped by Consumer Expectations for Value, Choice and Experience

UnitedHealthcare® today introduced its 2022 Medicare Advantage and prescription drug plans, offering expanded access to plans with differentiated value, simple and affordable benefit design and an unparalleled member experience all defined by what consumers say matters to them most.

Currently, more than 7.3 million peopleii are enrolled in UnitedHealthcare Medicare Advantage plans. In 2022, the company will expand its service area to reach 94% of Medicare consumers nationwide and maintain the industrys largest Medicare Advantage footprint including 3.1 million more people in 276 additional counties with access to a standard plan.

Dual Plans : Unitedhealthcare Dual Complete Plan Can Bring Additional Benefits

Dual Plans 101: UnitedHealthcare Dual Complete Plan Can Bring Additional Benefits, Convenience to Low-Income Seniors and People with Disabilities

If you interact with people eligible for both Medicare and Medicaid, you should know about an option that could offer a convenient approach to managing their health care.

Whats a Dual-Eligible Special Needs Plan ?

Most of us have heard of Medicare and Medicaid. Medicare provides health benefits for people over age 65 as well as people younger than 65 who qualify due to a disability. Medicaid provides health benefits for people with low income, though eligibility criteria vary by state.

A UnitedHealthcare Dual Complete plan is a DSNP that provides health benefits for people who are dually-eligible, meaning they qualify for both Medicare and Medicaid.

Who qualifies?

Anyone who meets the eligibility criteria for both Medicare and Medicaid is qualified to enroll in a DSNP. They often face unique health needs and could use assistance improving their health and quality of life. For instance they may:

• Have a disabling condition and struggle with daily activities such as bathing and dressing
• Suffer from a cognitive impairment or a mental disorder
• Receive care from multiple doctors to manage a variety of health conditions or
• Be more likely to need in-home care providers or other health and social services.

Why should someone consider a Dual Complete plan?

How can someone learn more about DSNP?

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Unitedhealthcare Connected Benefit Disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call , TTY 711, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.

You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al , TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

See How Dual Complete Works

Gives people with Medicaid and Medicare more coverage and more support.

You can keep your current Medicaid benefits and well give you more at no extra cost to you.

You could get credits to shop for approved health items.

More dental benefits.

More vision benefits.

And $0 drug copays with home delivery option.

All of this with Dual Complete, a plan that gives you more.

*In HI and AK, 8 a.m. to 8 p.m. Monday through Friday, 8 a.m. to 5 p.m. Saturday and Sunday.Benefits, features and/or devices vary by plan/area. Limitations and exclusions apply. Network size varies by market.1 Based on CMS and Internal Company Enrollment Data August 2021.2 $0 cost-share for in-network dental care, specified services only. If your plan offers out-of-network dental coverage and you see an out-of-network dentist you might be billed more, even for services listed as $0 copay.3 OTC and Healthy Food benefits have expiration timeframes. Call the plan or refer to your Evidence of Coverage for more information.4UnitedHealthcare® HouseCalls may not be available in all areas.5Allowance for contacts or frames with standard lenses covered in full either annually or every two years.

Looking for the federal governments Medicaid website? Look here at Medicaid.gov.

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Where Do I Get Started

We know that it can be stressful to navigate the insurance coverage process, but we strive to make it as smooth as possible.

We accept a variety of plans from insurance companies at all of our locations. To verify if your insurance plan is accepted for services across our health system, please review our list of accepted insurance companies below.

If your insurance company is accepted by Cleveland Clinic: Please contact your insurance company to confirm what care is covered by your plan as well as information on copayments, deductibles and coinsurance amounts. See what your out-of-pocket expenses will be using our cost estimator.

If your insurance company is not accepted by Cleveland Clinic: This means your insurance plan is considered out-of-network which can lead to greater out-of-pocket expenses for your care. Please contact your insurance company for more information about what your financial responsibility may be if you choose to receive care at Cleveland Clinic. Find more information about Cleveland Clinics out-of-network insurance process.

How To Qualify To Enroll In Unitedhealthcare Dual Complete Plan 1

If you qualify and enroll, this Local HMO plan replaces your Original Medicare coverage. To qualify, you must meet the following criteria:

• You have Medicare Part A and Medicare Part B .
• You live in the plan’s service area.
• You have both Medicare and MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States…..

If you’re not sure if you qualify for both Medicare and Medicaid, contact your local Medicaid office.

IMPORTANT: If you qualify for this plan based on your dual eligibility status, but you also have one or more chronic conditions, you should also investigate C-SNP plans in your areas, as they may offer a care manager to help coordinate your healthcare needs.

If you don’t qualify to join this plan, you might want to compare Medicare Advantage plans in Charles County, Maryland. Another popular option is to add a and a stand-alone .

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Medicare Vs Medicaid 101

An animated white speech bubble appears over an animated character’s yellow and blue head.

ON SCREEN TEXT: Medicaid 101

The speech bubble and character fall away. Blue text appears on a light blue background. White text appears in two animated circles below. The blue and green circles overlap.

ON SCREEN TEXT: Medicaid is a joint federal and state health program. Federal State

The text and circles fall away. Blue text appears surrounded by blue animated disks with dollar signs on them. Animated individual and family character graphics appear below the text.

ON SCREEN TEXT: It is for individuals, families and children with limited income & resources.

The text and graphics fall away. A white map of the continental U.S. appears on a light blue background. Green map marker icons dot the map. Blue text appears in the center of the map.

ON SCREEN TEXT: Each state creates its own Medicaid programs based on federal guidelines.

The map disappears. Blue text appears surrounded by animated green and white form and plus sign graphics.

ON SCREEN TEXT: Medicaid programs have mandatory benefits & optional benefits.

The text and graphics fall away. Blue text appears over an animated dark blue scale graphic. Yellow animated coins pile up on the left side of the scale and animated books pile up on the right side.

ON SCREEN TEXT: Medicaid costs will vary based on a person’s income and the state’s Medicaid rules.

ON SCREEN TEXT: Eligibility varies based on a state’s Medicaid rules.

Distinctive And Enhanced Offerings

We feel best about the plans we put into the marketplace when we know they are rooted in differentiated offerings supported by an exceptional member experience, said Noel. This year, we want our members to know that every expanded benefit, every enhanced program and every investment in a new offering is because we have been listening intently and shaping our plans to deliver on what we hear from consumers.

Added benefits and features that drive distinction for UnitedHealthcare members in 2022 include:

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Extra Help With Costs: Lis Premium Summary Table

UnitedHealthcare Dual Complete®

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

*This does not include any Medicare Part B premium you may have to pay.

If you arent getting extra help, you can see if you qualify by calling:

• 1-800-Medicare of TTY users call 1-877-486-2048 ,
• Your State Medicaid Office, or
• The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

Your health care needs are unique. These documents can help you make sure you get the right coverage.

Documents include Annual Notice of Changes, Enrollment Application, Enrollment Kit, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Vendor Information, Summary of Benefits, Other downloadable resources.

How Much Does Unitedhealthcare Dual Complete Plan 1 Cost

The premium on this plan is $37.00 per month. That includes your prescription drugs, as well. Plus, you must continue to pay your monthly Medicare Part B premiumThe Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary’s premium may be uplifted by an IRMAA surcharge if their income is above…. Copayments and/or coinsurances also apply with most healthcare services, except preventive care mandated by CMS.

Although the health plan itself does not have a deductible, the prescription drug plan does. It’s $480.00 per year. That means you pay 100% of your prescription costs until you’ve spent $480.00, then the plan will begin paying it’s share.

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How To Qualify To Enroll In Unitedhealthcare Dual Complete

If you qualify and enroll, this Local HMO plan replaces your Original Medicare coverage. To qualify, you must meet the following criteria:

• You have Medicare Part A and Medicare Part B .
• You live in the plan’s service area.
• You have both Medicare and MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States…..

If you’re not sure if you qualify for both Medicare and Medicaid, contact your local Medicaid office.

IMPORTANT: If you qualify for this plan based on your dual eligibility status, but you also have one or more chronic conditions, you should also investigate C-SNP plans in your areas, as they may offer a care manager to help coordinate your healthcare needs.

If you don’t qualify to join this plan, you might want to compare Medicare Advantage plans in Marion County, Missouri. Another popular option is to add a Missouri Medicare supplement plan and a stand-alone Missouri Medicare prescription drug plan.