UnitedHealthcare Medicare Gold (Regional PPO C-SNP) By UnitedHealthcare



UnitedHealthcare Medicare Gold (Regional PPO C-SNP) is a 2022 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 Medicare Gold (Regional PPO C-SNP) R2604-003 is a Chronic Condition SNP (C-SNP). A Chronic Condition SNP is for beneficiaries with the following severe or disabling chronic conditions: . If you have Medicare and you develop certain severe or disabling conditions you can join a Medicare SNP designed to serve people with those conditions at any time.



2022 Medicare Special Needs Plan Details

Plan Name:
UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
Plan ID:
R2604-003
Special Needs Type: Chronic or Disabling Condition
Provider: UnitedHealthcare
Plan Year:2022
Plan Type: Regional PPO
Monthly Premium C+D: $19.00


The UnitedHealthcare Medicare Gold (Regional PPO C-SNP) R2604-003 is available to residents in South Carolina, Georgia, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Medicare Gold (Regional PPO C-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 $1.80 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 Medicare Gold (Regional PPO C-SNP) plan has a monthly drug premium of $17.20 and a $210.00 drug deductible. This UnitedHealthcare plan offers a $17.20 Part D Basic Premium that is not 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 $17.20 . 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 Medicare Gold (Regional PPO C-SNP) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.30 for 75% low income subsidy $8.60 for 50% and $12.90 for 25%.



Part C Premium: $1.80
Part D (Drug) Premium: $17.20
Part D Supplemental Premium $0.00
Total Part D Premium: $17.20
Drug Deductible: $210.00
Tiers with No Deductible: 1
Benchmark: not below the regional benchmark
Type of Medicare Health Plan: Enhanced Alternative
Drug Benefit Type: Enhanced
Full LIS Premium: $0.00
75% LIS Premium: $4.30
50% LIS Premium: $8.60
25% LIS Premium: $12.90
Gap Coverage: Some Generics


Gap Coverage

In 2022 once you and your plan provider have spent $4430 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 offer additional coverage through the gap.




UnitedHealthcare Medicare Gold (Regional PPO C-SNP) Part-C Premium

UnitedHealthcare plan charges a $1.80 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.



R2604-003 Part-D Deductible and Premium

UnitedHealthcare Medicare Gold (Regional PPO C-SNP) has a monthly drug premium of $17.20 and a $210.00 drug deductible. This UnitedHealthcare plan offers a $17.20 Part D Basic Premium that is not 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 $17.20 . 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.



UnitedHealthcare Gap Coverage

In 2022 once you and your plan provider have spent $4430 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 prescription drugs unless your plan offers additional coverage. This UnitedHealthcare plan offer additional coverage through the gap.



R2604-003 Formulary or Drug Coverage

UnitedHealthcare Medicare Gold (Regional PPO C-SNP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 UnitedHealthcare Medicare Gold (Regional PPO C-SNP) R2604-003 Formulary here.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 NA $4
Tier 2 NA $12
Tier 3 NA $47
Tier 4 NA $100
Tier 5 NA 29%
*Initial Coverage Phase and 30 day supply







Reviews for UnitedHealthcare Medicare Gold (Regional PPO C-SNP) R2604



2021 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


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Monitoring Physical Activity


Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy


Member Experience with Health Plan

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


Member Complaints and Changes in UnitedHealthcare Medicare Gold (Regional PPO C-SNP) Plans Performance

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


Health Plan Customer Service Rating for UnitedHealthcare Medicare Gold (Regional PPO C-SNP)

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


UnitedHealthcare Medicare Gold (Regional PPO C-SNP) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language


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


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
Statin with Diabetes


Coverage Area for UnitedHealthcare Medicare Gold (Regional PPO C-SNP)

State: Medicare Plans in South Carolina
Medicare Plans in Georgia
County:Abbeville
Aiken
Allendale
Anderson
Appling
Atkinson
Bacon
Baker
Baldwin
Bamberg
Banks
Barnwell
Barrow
Bartow
Beaufort
Ben Hill
Berkeley
Berrien
Bibb
Bleckley
Brantley
Brooks
Bryan
Bulloch
Burke
Butts
Calhoun
Calhoun
Camden
Candler
Carroll
Catoosa
Charleston
Charlton
Chatham
Chattahoochee
Chattooga
Cherokee
Cherokee
Chester
Chesterfield
Clarendon
Clarke
Clay
Clayton
Clinch
Cobb
Coffee
Colleton
Colquitt
Columbia
Cook
Coweta
Crawford
Crisp
Dade
Darlington
Dawson
Decatur
DeKalb
Dillon
Dodge
Dooly
Dorchester
Dougherty
Douglas
Early
Echols
Edgefield
Effingham
Elbert
Emanuel
Evans
Fairfield
Fannin
Fayette
Florence
Floyd
Forsyth
Franklin
Fulton
Georgetown
Gilmer
Glascock
Glynn
Gordon
Grady
Greene
Greenville
Greenwood
Gwinnett
Habersham
Hall
Hampton
Hancock
Haralson
Harris
Hart
Heard
Henry
Horry
Houston
Irwin
Jackson
Jasper
Jasper
Jeff Davis
Jefferson
Jenkins
Johnson
Jones
Kershaw
Lamar
Lancaster
Lanier
Laurens
Laurens
Lee
Lee
Lexington
Liberty
Lincoln
Long
Lowndes
Lumpkin
Macon
Madison
Marion
Marion
Marlboro
McCormick
McDuffie
McIntosh
Meriwether
Miller
Mitchell
Monroe
Montgomery
Morgan
Murray
Muscogee
Newberry
Newton
Oconee
Oconee
Oglethorpe
Orangeburg
Paulding
Peach
Pickens
Pickens
Pierce
Pike
Polk
Pulaski
Putnam
Quitman
Rabun
Randolph
Richland
Richmond
Rockdale
Saluda
Schley
Screven
Seminole
Spalding
Spartanburg
Stephens
Stewart
Sumter
Sumter
Talbot
Taliaferro
Tattnall
Taylor
Telfair
Terrell
Thomas
Tift
Toombs
Towns
Treutlen
Troup
Turner
Twiggs
Union
Union
Upson
Walker
Walton
Ware
Warren
Washington
Wayne
Webster
Wheeler
White
Whitfield
Wilcox
Wilkes
Wilkinson
Williamsburg
Worth
York


Source: CMS.

Plans as of September 1, 2021.

Notes: Data are subject to change. All contracts for 2022 have not been finalized. For 2022, 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 2022 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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