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) R6801-009 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:
R6801-009
Special Needs Type: Chronic or Disabling Condition
Provider: UnitedHealthcare
Plan Year:2022
Plan Type: Regional PPO
Monthly Premium C+D: $29.00
Part C Premium: $18.20
Part D (Drug) Premium: $10.80
Part D Supplemental Premium $0.00
Total Part D Premium: $10.80
Drug Deductible: $295.00
Tiers with No Deductible: 1
Benchmark: not below the regional benchmark
Type of Medicare Health Plan: Enhanced Alternative
Drug Benefit Type: Enhanced
Gap Coverage: Some Generics


The UnitedHealthcare Medicare Gold (Regional PPO C-SNP) R6801-009 is available to residents in Texas, 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.



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 $18.20 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.



R6801-009 Part-D Deductible and Premium

UnitedHealthcare Medicare Gold (Regional PPO C-SNP) has a monthly drug premium of $10.80 and a $295.00 drug deductible. This UnitedHealthcare plan offers a $10.80 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 $10.80 . 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.



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.



Premium Assistance

The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. 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 offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $2.70 for 75% low income subsidy $5.40 for 50% and $8.10 for 25%.



Full LIS Premium:$0.00
75% LIS Premium:$2.70
50% LIS Premium:$5.40
25% LIS Premium:$8.10


R6801-009 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) R6801-009 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 28%
*Initial Coverage Phase and 30 day supply







Reviews for UnitedHealthcare Medicare Gold (Regional PPO C-SNP) R6801



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 Texas
County:

Anderson



Andrews



Angelina



Aransas



Archer



Armstrong



Atascosa



Austin



Bailey



Bandera



Bastrop



Baylor



Bee



Bell



Bexar



Blanco



Borden



Bosque



Bowie



Brazoria



Brazos



Brewster



Briscoe



Brooks



Brown



Burleson



Burnet



Caldwell



Calhoun



Callahan



Cameron



Camp



Carson



Cass



Castro



Chambers



Cherokee



Childress



Clay



Cochran



Coke



Coleman



Collin



Collingsworth



Colorado



Comal



Comanche



Concho



Cooke



Coryell



Cottle



Crane



Crockett



Crosby



Culberson



Dallam



Dallas



Dawson



Deaf Smith



Delta



Denton



DeWitt



Dickens



Dimmit



Donley



Duval



Eastland



Ector



Edwards



El Paso



Ellis



Erath



Falls



Fannin



Fayette



Fisher



Floyd



Foard



Fort Bend



Franklin



Freestone



Frio



Gaines



Galveston



Garza



Gillespie



Glasscock



Goliad



Gonzales



Gray



Grayson



Gregg



Grimes



Guadalupe



Hale



Hall



Hamilton



Hansford



Hardeman



Hardin



Harris



Harrison



Hartley



Haskell



Hays



Hemphill



Henderson



Hidalgo



Hill



Hockley



Hood



Hopkins



Houston



Howard



Hudspeth



Hunt



Hutchinson



Irion



Jack



Jackson



Jasper



Jeff Davis



Jefferson



Jim Hogg



Jim Wells



Johnson



Jones



Karnes



Kaufman



Kendall



Kenedy



Kent



Kerr



Kimble



King



Kinney



Kleberg



Knox



La Salle



Lamar



Lamb



Lampasas



Lavaca



Lee



Leon



Liberty



Limestone



Lipscomb



Live Oak



Llano



Loving



Lubbock



Lynn



Madison



Marion



Martin



Mason



Matagorda



Maverick



McCulloch



McLennan



McMullen



Medina



Menard



Midland



Milam



Mills



Mitchell



Montague



Montgomery



Moore



Morris



Motley



Nacogdoches



Navarro



Newton



Nolan



Nueces



Ochiltree



Oldham



Orange



Palo Pinto



Panola



Parker



Parmer



Pecos



Polk



Potter



Presidio



Rains



Randall



Reagan



Real



Red River



Reeves



Refugio



Roberts



Robertson



Rockwall



Runnels



Rusk



Sabine



San Augustine



San Jacinto



San Patricio



San Saba



Schleicher



Scurry



Shackelford



Shelby



Sherman



Smith



Somervell



Starr



Stephens



Sterling



Stonewall



Sutton



Swisher



Tarrant



Taylor



Terrell



Terry



Throckmorton



Titus



Tom Green



Travis



Trinity



Tyler



Upshur



Upton



Uvalde



Val Verde



Van Zandt



Victoria



Walker



Waller



Ward



Washington



Webb



Wharton



Wheeler



Wichita



Wilbarger



Willacy



Williamson



Wilson



Winkler



Wise



Wood



Yoakum



Young



Zapata



Zavala





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.

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