2015 AARP MedicareComplete (HMO) H1080-004 By UnitedHealthcare

AARP MedicareComplete (HMO) By UnitedHealthcare



AARP MedicareComplete (HMO) is a 2015 Medicare Advantage ("Part C" or "MA Plan") plan by UnitedHealthcare. This plan from UnitedHealthcare works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for AARP MedicareComplete (HMO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.



2015 Medicare Advantage Plan Details

Plan Name:
AARP MedicareComplete (HMO)
Plan ID:
H1080-004
Provider: UnitedHealthcare
Plan Year:2015
Plan Type: Local HMO
Monthly Premium C+D: $0.00
MOOP: $5,900


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Coverage Area for AARP MedicareComplete (HMO)

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The AARP MedicareComplete (HMO) H1080-004 is available to residents in Florida, and has a in-network Maximum Out-of-Pocket limit of $5,900 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in AARP MedicareComplete (HMO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $5,900 This is a very nice safety net. This plan includes additional Medicare prescription drug (Part-D) coverage.

AARP MedicareComplete (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you need special care for a physician specialist, your primary care physician will make the arrangements and tell you where you can go in the network. You will need your PCPs okay, called a referral. Without getting a referral or services received from out-of-network providers are not typically covered by the plan.





Ratings for AARP MedicareComplete (HMO) H1080

2015 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing


Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints and Changes in AARP MedicareComplete (HMO) Plans Performance

Total Rating
Members Leaving the Plan
Complaints about Health Plan
Health Plan Quality Improvement


Health Plan Customer Service Rating for AARP MedicareComplete (HMO)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancel Screening
Cardiovascular Screening
Diabetes Care
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment


Ratings For Managing Chronic And Long Term Care

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Diabetes Care - Cholesterol
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions


Ratings For Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
High Risk Medication
Diabetes Treatment
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)


Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


AARP MedicareComplete (HMO) Drug Plan Customer Service ratings

Total Rating
Appeals Auto Forward
Appeals Upheld


Part-C Premium

UnitedHealthcare plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.



Part-D Deductible and Premium

The AARP MedicareComplete (HMO) plan has a monthly drug premium of $0.00 and a $220.00 drug deductible. This UnitedHealthcare plan offers a $0.00 Part D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by UnitedHealthcare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.



Premium Assistance

Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The AARP MedicareComplete (HMO) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $0.00 for 75% low income subsidy $0.00 for 50% and $0.00 for 25%.



Part C Premium: $0.00
Part D (Drug) Premium: $0.00
Part D Supplemental Premium $0.00
Total Part D Premium: $0.00
Drug Deductible: $220.00
Tiers with No Deductible: 1
Benchmark: below the regional benchmark
Type of Medicare Health Plan: Basic Alternative
Drug Benefit Type: Basic
Full LIS Premium: $0.00
75% LIS Premium: $0.00
50% LIS Premium: $0.00
25% LIS Premium: $0.00
Inital Coverage Limit:$2960
Gap Coverage: No


Gap Coverage

In 2015 once you and your plan provider have spent $2,960 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will still receive a 55% discount on brand-name drugs and a 35% discount on generic drugs. Once you reach the coverage gap you will pay 45% of the plan's cost for covered brand-name prescription drugs unless your plan offers additional coverage. This UnitedHealthcare plan does not offer additional coverage through the gap.





Source: CMS.

Plans as of September 2, 2014.

Star Rating as of Oct 3, 2014.

For More Information on Ratings Please See the CMS Tech Notes Here.

Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit

Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

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