2018 UnitedHealthcare Dual Complete RP (Regional PPO SNP) DS-R7444

UnitedHealthcare Dual Complete RP (Regional PPO SNP) By UnitedHealthcare



UnitedHealthcare Dual Complete RP (Regional PPO SNP) is a 2018 Medicare Advantage Special Needs Plan plan by UnitedHealthcare. This plan from UnitedHealthcare works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. UnitedHealthcare Dual Complete RP (Regional PPO SNP) DS-R7444 is a Dual Eligible Special Needs Plan (D-SNP). A Dual Eligible SNP is for beneficiaries who are eligible for both Medicare and Medicaid. If you have Medicare and get help from Medicaid you can join any Medicare SNP you qualify for or switch plans at any time.



2018 Medicare Special Needs Plan Details

Plan Name:
UnitedHealthcare Dual Complete RP (Regional PPO SNP)
Plan ID:
DS-R7444
Special Needs Type: Dual-Eligible
Provider: UnitedHealthcare
Plan Year:2018
Plan Type: Regional PPO
Monthly Premium C+D: $19.80


COMPARE AND SAVE ON MEDICARE INSURANCE




Coverage Area for UnitedHealthcare Dual Complete RP (Regional PPO SNP)



The UnitedHealthcare Dual Complete RP (Regional PPO SNP) DS-R7444 is available to residents in Florida, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Dual Complete RP (Regional PPO SNP) is a Regional PPO. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

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 UnitedHealthcare Dual Complete RP (Regional PPO SNP) plan has a monthly drug premium of $19.80 and a $405.00 drug deductible. This UnitedHealthcare plan offers a $19.80 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 $19.80. 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 UnitedHealthcare Dual Complete RP (Regional PPO SNP) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.90 for 75% low income subsidy $9.90 for 50% and $14.80 for 25%.



Part C Premium: $0.00
Part D (Drug) Premium: $19.80
Part D Supplemental Premium $0.00
Total Part D Premium: $19.80
Drug Deductible: $405.00
Tiers with No Deductible: 0
Benchmark: below the regional benchmark
Type of Medicare Health Plan: Defined Standard Benefit
Drug Benefit Type: Basic
Full LIS Premium: $0.00
75% LIS Premium: $4.90
50% LIS Premium: $9.90
25% LIS Premium: $14.80
Initial Coverage Limit:$3750
Gap Coverage: No


Gap Coverage

In 2018 once you and your plan provider have spent $3,750 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 35% for brand-name drugs and 44% on generic drugs unless your plan offers additional coverage. This UnitedHealthcare plan does not offer additional coverage through the gap.



Plan Services






Health plan deductible


Coming soon



Diagnostic procedures/lab services/imaging


Diagnostic tests and procedures In-Network 0% or 20%
Diagnostic tests and procedures Out-of-Network 40%
Lab services In-Network $0
Lab services Out-of-Network $0 copay
Diagnostic radiology services (e.g., MRI) In-Network 0% or 20%
Diagnostic radiology services (e.g., MRI) Out-of-Network 40%
Outpatient x-rays In-Network 0% or 20%
Outpatient x-rays Out-of-Network 40%



Hearing


Hearing exam In-Network $0 copay
Hearing exam Out-of-Network 40%
Fitting/evaluation Not covered
Hearing aids In-Network $0 copay
Hearing aids Out-of-Network $0 copay



Preventive dental


Oral exam In-Network $0 copay
Oral exam Out-of-Network $0 copay
Cleaning In-Network $0 copay
Cleaning Out-of-Network $0 copay
Fluoride treatment Not covered
Dental x-ray(s) In-Network $0 copay
Dental x-ray(s) Out-of-Network $0 copay



Comprehensive dental


Non-routine services In-Network $0
Non-routine services Out-of-Network $0 copay
Diagnostic services Not covered
Restorative services In-Network $0
Restorative services Out-of-Network $0 copay
Endodontics In-Network $0
Endodontics Out-of-Network $0 copay
Periodontics In-Network $0
Periodontics Out-of-Network $0 copay
Extractions In-Network $0
Extractions Out-of-Network $0 copay
Prosthodontics, other oral/maxillofacial surgery, other services In-Network $0
Prosthodontics, other oral/maxillofacial surgery, other services Out-of-Network $0 copay



Vision


Routine eye exam In-Network $0
Routine eye exam Out-of-Network 40%
Other Not covered
Contact lenses In-Network $0 copay
Contact lenses Out-of-Network $0 copay
Eyeglasses (frames and lenses) Not covered
Eyeglass frames In-Network $0 copay
Eyeglass frames Out-of-Network $0 copay
Eyeglass lenses In-Network $0 copay
Eyeglass lenses Out-of-Network $0 copay
Upgrades Not covered



Mental health services


In-Network $0 or $1,300 per stay
Out-of-Network 40% per stay
Outpatient group therapy visit with a psychiatrist In-Network 0% or 19%
Outpatient group therapy visit with a psychiatrist Out-of-Network 40%
Outpatient individual therapy visit with a psychiatrist In-Network 0% or 19%
Outpatient individual therapy visit with a psychiatrist Out-of-Network 40%
Outpatient group therapy visit In-Network 0% or 19%
Outpatient group therapy visit Out-of-Network 40%
Outpatient individual therapy visit In-Network 0% or 19%
Outpatient individual therapy visit Out-of-Network 40%



Skilled Nursing Facility


In-Network Coming soon
Out-of-Network 40% per stay



Rehabilitation services


Occupational therapy visit In-Network 0% or 19%
Occupational therapy visit Out-of-Network 40%
Physical therapy and speech and language therapy visit In-Network 0% or 19%
Physical therapy and speech and language therapy visit Out-of-Network 40%



Ambulance


In-Network 0% or 20%
Out-of-Network 20%



Transportation


In-Network $0 copay
Out-of-Network 75%



Other health plan deductibles?


In-Network No



Foot care (podiatry services)


Foot exams and treatment In-Network 0% or 19%
Foot exams and treatment Out-of-Network 40%
Routine foot care In-Network $0
Routine foot care Out-of-Network 40%



Medical equipment/supplies


Durable medical equipment (e.g., wheelchairs, oxygen) In-Network 0% or 20% per item
Durable medical equipment (e.g., wheelchairs, oxygen) Out-of-Network 40% per item
Prosthetics (e.g., braces, artificial limbs) In-Network 0% or 20% per item
Prosthetics (e.g., braces, artificial limbs) Out-of-Network 40% per item
Diabetes supplies In-Network $0 per item
Diabetes supplies Out-of-Network 40% per item



Wellness programs (e.g., fitness, nursing hotline)


Covered



Medicare Part B drugs


Chemotherapy In-Network 0% or 20%
Chemotherapy Out-of-Network 40%
Other Part B drugs In-Network 0% or 20%
Other Part B drugs Out-of-Network 40%



Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)


$10,000 In and Out-of-network
$6,700 In-network



Optional supplemental benefits


No



Inpatient hospital coverage


In-Network $0 or $1,300 per stay
$0 for days 91 and beyond
Out-of-Network 40% per stay



Outpatient hospital coverage


In-Network 0% or 20% per visit
Out-of-Network 40% per visit



Doctor visits


Primary In-Network $0 copay
Primary Out-of-Network 40% per visit
Specialist In-Network 0% or 19% per visit
Specialist Out-of-Network 40% per visit



Preventive care


In-Network $0 copay
Out-of-Network 0-40%



Emergency care/Urgent care


Emergency $0 or $80 per visit (always covered)
Urgent care $0 or $65 per visit (always covered)




Ratings for UnitedHealthcare Dual Complete RP (Regional PPO SNP) DS

2018 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 UnitedHealthcare Dual Complete RP (Regional PPO SNP) Plans Performance

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


Health Plan Customer Service Rating for UnitedHealthcare Dual Complete RP (Regional PPO SNP)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language


Staying Healthy, Screening, Testing, & Vaccines

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


Managing Chronic And Long Term Care for Older Adults

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
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions


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
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR


Ratings For Member Complaints and Changes in the Drug Plans Performance

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


UnitedHealthcare Dual Complete RP (Regional PPO SNP) Drug Plan Customer Service ratings

Total Rating
Appeals Auto Forward
Appeals Upheld
Call Center, TTY, Foreign Language


Source: CMS.

Plans as of September 2, 2017.

Star Rating as of September 6, 2017.

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

Notes: Data are subject to change. All contracts for 2018 have not been finalized. For 2018, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.

Includes 2018 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

Call For A licensed Sales Agent

1-855-492-4169

  • Mon-Fri 8:30am-8:00pm


Or Enroll Online Here

Call to Enroll!