2020 UnitedHealthcare Dual Complete (HMO D-SNP) DS-H6595

UnitedHealthcare Dual Complete (HMO D-SNP) By UnitedHealthcare



UnitedHealthcare Dual Complete (HMO D-SNP) is a 2020 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 (HMO D-SNP) DS-H6595 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.



2020 Medicare Special Needs Plan Details

Plan Name:
UnitedHealthcare Dual Complete (HMO D-SNP)
Plan ID:
DS-H6595
Special Needs Type: Dual-Eligible
Provider: UnitedHealthcare
Plan Year:2020
Plan Type: Local HMO
Monthly Premium C+D: $29.50


COMPARE AND SAVE ON MEDICARE INSURANCE




The UnitedHealthcare Dual Complete (HMO D-SNP) DS-H6595 is available to residents in Kentucky, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Dual Complete (HMO D-SNP) 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.



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 (HMO D-SNP) plan has a monthly drug premium of $29.50 and a $435.00 drug deductible. This UnitedHealthcare plan offers a $29.50 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 $29.50. 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 (HMO D-SNP) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $7.40 for 75% low income subsidy $14.70 for 50% and $22.10 for 25%.



Part C Premium: $0.00
Part D (Drug) Premium: $29.50
Part D Supplemental Premium $0.00
Total Part D Premium: $29.50
Drug Deductible: $435.00
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: $7.40
50% LIS Premium: $14.70
25% LIS Premium: $22.10
Gap Coverage: No


Gap Coverage

In 2020 once you and your plan provider have spent $4020 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. This UnitedHealthcare plan does not offer additional coverage through the gap.




UnitedHealthcare Drug Coverage and Formulary

A formulary is divided into tiers or levels of coverage based on the type or usage of your medication or benefit categories, according to drug costs. Each tier will have a defined out-of-pocket cost that you must pay before receiving the drug. You can see complete 2020 UnitedHealthcare Dual Complete (HMO D-SNP) H6595-001 Formulary here.

Drug Tier Copay
Preferred
Copay
Nonpreferred
1 NA $0
2 NA $0
3 NA $0
4 NA $0
5 NA $0
*Initial Coverage Phase and 30 day supply

See the 2020 UnitedHealthcare Formulary



2019 Plan Services

(*2020 Plan services will be added when available)




Health plan deductible


$0



Emergency care/Urgent care


Emergency $0 copay
Urgent care $0 copay



Diagnostic procedures/lab services/imaging


Diagnostic tests and procedures $0 copay
Lab services $0 copay
Diagnostic radiology services (e.g., MRI) $0 copay
Outpatient x-rays $0 copay



Hearing


Hearing exam $0 copay
Fitting/evaluation Not covered
Hearing aids $0 copay



Preventive dental


Oral exam $0 copay
Cleaning $0 copay
Fluoride treatment $0 copay
Dental x-ray(s) $0 copay



Comprehensive dental


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



Vision


Routine eye exam $0
Other Not covered
Contact lenses $0 copay
Eyeglasses (frames and lenses) Not covered
Eyeglass frames $0 copay
Eyeglass lenses $0 copay
Upgrades Not covered



Mental health services


Inpatient hospital - psychiatric $0 copay
Outpatient group therapy visit with a psychiatrist $0 copay
Outpatient individual therapy visit with a psychiatrist $0 copay
Outpatient group therapy visit $0 copay
Outpatient individual therapy visit $0 copay



Skilled Nursing Facility


$0 copay



Rehabilitation services


Occupational therapy visit $0 copay
Physical therapy and speech and language therapy visit $0 copay



Ground ambulance


$0 copay



Other health plan deductibles?


In-Network No



Transportation


$0 copay



Foot care (podiatry services)


Foot exams and treatment $0 copay
Routine foot care $0



Medical equipment/supplies


Durable medical equipment (e.g., wheelchairs, oxygen) $0 copay
Prosthetics (e.g., braces, artificial limbs) $0 copay
Diabetes supplies $0 copay



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


Covered



Medicare Part B drugs


Chemotherapy $0 copay
Other Part B drugs $0 copay



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


$6,700 In-network



Optional supplemental benefits


No



Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?


In-Network No



Inpatient hospital coverage


$0 copay



Outpatient hospital coverage


$0 copay



Doctor visits


Primary $0 copay
Specialist $0 copay



Preventive care


$0 copay





Coverage Area for UnitedHealthcare Dual Complete (HMO D-SNP)



Source: CMS.

Plans as of September 4, 2019.

Star Rating as of October 11, 2019.

Plan Services are 2019 information as reference. 2020 information will be added when released.

Notes: Data are subject to change. All contracts for 2020 have not been finalized. For 2020, 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 2020 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

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