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



UnitedHealthcare Medicare Silver (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 Silver (Regional PPO C-SNP) R2604-002 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 Silver (Regional PPO C-SNP)
Plan ID:
R2604-002
Special Needs Type: Chronic or Disabling Condition
Provider: UnitedHealthcare
Plan Year:2022
Plan Type: Regional PPO
Monthly Premium C+D: $9.20
Part C Premium: $0.00
Part D (Drug) Premium: $9.20
Part D Supplemental Premium $0.00
Total Part D Premium: $9.20
Drug Deductible: $480.00
Tiers with No Deductible: 0
Benchmark: below the regional benchmark
Type of Medicare Health Plan: Defined Standard Benefit
Drug Benefit Type: Basic
Gap Coverage: No Gap Coverage


The UnitedHealthcare Medicare Silver (Regional PPO C-SNP) R2604-002 is available to residents in South Carolina, Georgia, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Medicare Silver (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 Silver (Regional PPO C-SNP) 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.



R2604-002 Part-D Deductible and Premium

UnitedHealthcare Medicare Silver (Regional PPO C-SNP) has a monthly drug premium of $9.20 and a $480.00 drug deductible. This UnitedHealthcare plan offers a $9.20 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 $9.20 . 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.



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 Silver (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 $2.30 for 75% low income subsidy $4.60 for 50% and $6.90 for 25%.



Full LIS Premium:$0.00
75% LIS Premium:$2.30
50% LIS Premium:$4.60
25% LIS Premium:$6.90


R2604-002 Formulary or Drug Coverage

UnitedHealthcare Medicare Silver (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 Silver (Regional PPO C-SNP) R2604-002 Formulary here.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 NA 25%
Tier 2 NA 25%
Tier 3 NA 25%
Tier 4 NA 25%
Tier 5 NA 25%
*Initial Coverage Phase and 30 day supply







Reviews for UnitedHealthcare Medicare Silver (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 Silver (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 Silver (Regional PPO C-SNP)

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


UnitedHealthcare Medicare Silver (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 Silver (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.

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