- United Healthcare Specialist Copay Cards
- Unitedhealthcare Chiropractic Copay
- United Healthcare Waiver Of Copay
- United Healthcare Specialist Copay Card
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Please use the following cost-sharing information when treating and servicing UnitedHealthcare Medicare Advantage members. If you have questions, contact your Provider Advocate or call Provider Services at 877-842-3210. Benefit Copay and coinsurance guidelines. Alcohol Misuse Counseling.
UnitedHealthcare Dual Complete (PPO 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 (PPO D-SNP) DS-H0271 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: | |
|---|---|
| Plan ID: | DS-H0271 |
| Special Needs Type: | Dual-Eligible |
| Provider: | UnitedHealthcare |
| Plan Year: | 2020 |
| Plan Type: | Local PPO |
| Monthly Premium C+D: | $28.00 |
The UnitedHealthcare Dual Complete (PPO D-SNP) DS-H0271 is available to residents in Indiana, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Dual Complete (PPO D-SNP) is a Local 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 (PPO D-SNP) plan has a monthly drug premium of $28.00 and a $435.00 drug deductible. This UnitedHealthcare plan offers a $28.00 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 $28.00. 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 (PPO 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 $7.00 for 75% low income subsidy $14.00 for 50% and $21.00 for 25%.
| Part C Premium: | $0.00 |
|---|---|
| Part D (Drug) Premium: | $28.00 |
| Part D Supplemental Premium | $0.00 |
| Total Part D Premium: | $28.00 |
| 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: | $7.00 |
| 50% LIS Premium: | $14.00 |
| 25% LIS Premium: | $21.00 |
| 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 (PPO D-SNP) H0271-005 Formulary here.
See the 2020 UnitedHealthcare Formulary
(*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 | Out-of-Network | 30% |
|---|---|---|
| Diagnostic tests and procedures | In-Network | $0 copay |
| Lab services | Out-of-Network | $0 copay |
| Lab services | In-Network | $0 copay |
| Diagnostic radiology services (e.g., MRI) | Out-of-Network | 30% |
| Diagnostic radiology services (e.g., MRI) | In-Network | $0 copay |
| Outpatient x-rays | Out-of-Network | 30% |
| Outpatient x-rays | In-Network | $0 copay |
Hearing
| Hearing exam | Out-of-Network | 30% |
|---|---|---|
| Hearing exam | In-Network | $0 copay |
| Fitting/evaluation | Not covered | |
| Hearing aids | Out-of-Network | $0 copay |
| Hearing aids | In-Network | $0 copay |
Preventive dental
| Oral exam | Out-of-Network | $0 copay |
|---|---|---|
| Oral exam | In-Network | $0 copay |
| Cleaning | Out-of-Network | $0 copay |
| Cleaning | In-Network | $0 copay |
| Fluoride treatment | Out-of-Network | $0 copay |
| Fluoride treatment | In-Network | $0 copay |
| Dental x-ray(s) | Out-of-Network | $0 copay |
| Dental x-ray(s) | In-Network | $0 copay |
Comprehensive dental
| Non-routine services | Not covered | |
|---|---|---|
| Diagnostic services | Out-of-Network | $0 copay |
| Diagnostic services | In-Network | $0 |
| Restorative services | Out-of-Network | $0 copay |
| Restorative services | In-Network | $0 |
| Endodontics | Out-of-Network | $0 copay |
| Endodontics | In-Network | $0 |
| Periodontics | Out-of-Network | $0 copay |
| Periodontics | In-Network | $0 |
| Extractions | Out-of-Network | $0 copay |
| Extractions | In-Network | $0 |
| Prosthodontics, other oral/maxillofacial surgery, other services | Out-of-Network | $0 copay |
| Prosthodontics, other oral/maxillofacial surgery, other services | In-Network | $0 |
Vision
| Routine eye exam | Out-of-Network | 30% |
|---|---|---|
| Routine eye exam | In-Network | $0 |
| Other | Not covered | |
| Contact lenses | Out-of-Network | 30% |
| Contact lenses | In-Network | $0 copay |
| Eyeglasses (frames and lenses) | Out-of-Network | 30% |
| Eyeglasses (frames and lenses) | In-Network | $0 copay |
| Eyeglass frames | Not covered | |
| Eyeglass lenses | Not covered | |
| Upgrades | Not covered |
Mental health services
| Inpatient hospital - psychiatric | Out-of-Network | 30% per stay |
|---|---|---|
| Inpatient hospital - psychiatric | In-Network | $0 copay |
| Outpatient group therapy visit with a psychiatrist | Out-of-Network | 30% |
| Outpatient group therapy visit with a psychiatrist | In-Network | $0 copay |
| Outpatient individual therapy visit with a psychiatrist | Out-of-Network | 30% |
| Outpatient individual therapy visit with a psychiatrist | In-Network | $0 copay |
| Outpatient group therapy visit | Out-of-Network | 30% |
| Outpatient group therapy visit | In-Network | $0 copay |
| Outpatient individual therapy visit | Out-of-Network | 30% |
| Outpatient individual therapy visit | In-Network | $0 copay |
Skilled Nursing Facility
| Out-of-Network | 30% per stay |
|---|---|
| In-Network | $0 copay |
Rehabilitation services
| Occupational therapy visit | Out-of-Network | 30% |
|---|---|---|
| Occupational therapy visit | In-Network | $0 copay |
| Physical therapy and speech and language therapy visit | Out-of-Network | 30% |
| Physical therapy and speech and language therapy visit | In-Network | $0 copay |
Ground ambulance
| Out-of-Network | 20% |
|---|---|
| In-Network | $0 copay |
Other health plan deductibles?
| In-Network | No |
|---|
United Healthcare Specialist Copay Cards
Transportation
| Out-of-Network | 75% |
|---|---|
| In-Network | $0 copay |
Foot care (podiatry services)
| Foot exams and treatment | Out-of-Network | 30% |
|---|---|---|
| Foot exams and treatment | In-Network | $0 copay |
| Routine foot care | Out-of-Network | 30% |
| Routine foot care | In-Network | $0 |
Medical equipment/supplies
| Durable medical equipment (e.g., wheelchairs, oxygen) | Out-of-Network | 30% per item |
|---|---|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | In-Network | $0 copay |
| Prosthetics (e.g., braces, artificial limbs) | Out-of-Network | 30% per item |
| Prosthetics (e.g., braces, artificial limbs) | In-Network | $0 copay |
| Diabetes supplies | Out-of-Network | 30% per item |
| Diabetes supplies | In-Network | $0 copay |
Wellness programs (e.g., fitness, nursing hotline)
| Covered |
|---|
Medicare Part B drugs
| Chemotherapy | Out-of-Network | 20% |
|---|---|---|
| Chemotherapy | In-Network | $0 copay |
| Other Part B drugs | Out-of-Network | 20% |
| Other Part B drugs | In-Network | $0 copay |
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 |
|---|
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
| In-Network | No |
|---|
Inpatient hospital coverage
| Out-of-Network | 30% per stay |
|---|---|
| In-Network | $0 copay |
Outpatient hospital coverage
| Out-of-Network | 30% per visit |
|---|---|
| In-Network | $0 copay |
Doctor visits
| Primary | Out-of-Network | 30% per visit |
|---|---|---|
| Primary | In-Network | $0 copay |
| Specialist | Out-of-Network | 30% per visit |
| Specialist | In-Network | $0 copay |
Preventive care
| Out-of-Network | 0-30% |
|---|---|
| In-Network | $0 copay |
Coverage Area for UnitedHealthcare Dual Complete (PPO D-SNP)
| State: | Indiana |
|---|---|
| County: | Adams, Allen, Bartholomew, Benton, Blackford, Boone, Brown, Carroll, Cass, Clark, Clay, Clinton, Crawford, Daviess, De Kalb, Dearborn, Decatur, Delaware, Dubois, Elkhart, Fayette, Floyd, Fountain, Franklin, Fulton, Gibson, Grant, Greene, Hamilton, Hancock, Harrison, Hendricks, Henry, Howard, Huntington, Jackson, Jasper, Jay, Jefferson, Jennings, Johnson, Knox, Kosciusko, La Porte, Lagrange, Lake, Lawrence, Madison, Marion, Marshall, Martin, Miami, Monroe, Montgomery, Morgan, Newton, Noble, Ohio, Orange, Owen, Parke, Perry, Pike, Porter, Posey, Pulaski, Putnam, Randolph, Ripley, Rush, Scott, Shelby, Spencer, St. Joseph, Starke, Steuben, Sullivan, Switzerland, Tippecanoe, Tipton, Union, Vanderburgh, Vermillion, Vigo, Wabash, Warren, Warrick, Washington, Wells, White, Whitley, |
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.
With a wide variety of plan types and coverage options, United Healthcare is a major insurance carrier in the United States, offering multiple Medicare Advantage plans. Headquartered in Minnetonka, Minnesota, United Healthcare and subsequently United Healthcare Medicare was founded in 1977. It has grown considerably over the last 40 years.
The company provides coverage to 115 million individuals and is the company that provides AARP with their own Medicare Advantage Program. It’s also the company that provides AARP with its own Medicare Advantage Program.
04/24/2017 Update: Use the form below to obtain real time pricing for 2017 United Healthcare (UHC) Medicare Supplement and Medicare Advantage Plans. Review detailed information regarding prescription drug coverage and co-pays. Please note that you will not be contacted by multiple parties. HealthNetwork respects your privacy and works very hard to ensure a quality consumer experience.
Medicare Advantage (Medicare Part C) plans through United Healthcare provide the same benefits as original Medicare. They include Part A and Part B, but they also have a few extra services included, like routine hearing and vision care. Some plans also include Part D or prescription drug coverage.
Most plans under UnitedHealthcare are with AARP. These plans have urgent care, worldwide emergency care coverage and annual out-of-pocket maximums to prevent you from over-spending by staying in budget. There are also many educational materials and videos on United Healthcare’s website. You can view the different Medicare Advantage plans, see tutorials or chat with an agent to get more help.
Most plans won’t cost anything more than what you already pay for Part B with United Healthcare. For this reason, they have some of the best services and prices for Medicare Advantage enrollees.
If you have any questions at all, don't hesitate to call and speak with one of our healthcare professionals. Available 24/7 at 1-800-810-1437TTY 711
United Healthcare Plans
There are four types of Medicare Advantage plans available with United Healthcare.
United Healthcare Health Maintenance Organization (HMO)
Under the United Healthcare HMO plan, you must get services from a network of local providers. Emergency room, urgent care visits and renal dialysis services are exempt. You may also need a referral to see a specialist. The benefit of an HMO plan is that your out-of-pocket expenses will usually be lower than a PPO or POS plan.
United Healthcare Point-of-Service (POS)
POS plans are similar to HMO plans except that you are able to see providers for certain services outside the plan’s network. However, out-of-network providers may cost more. You may also need to get a referral to a specialist. Your out-of-pocket costs are usually higher than with an HMO but lower than you’d expect with a PPO plan.
United Healthcare Preferred Provider Organization (PPO)
You can see providers for all covered services even if they are out of your network, but it will probably cost more. You do not have to get a referral for a specialist. This plan has the highest out-of-pocket costs.
United Healthcare Private Fee-for-Service (PFFS)
Only non-network PFFS plans are available. You can use any providers you choose as long as they are Medicare-eligible, and you can visit any hospital that agrees to the plan’s terms and conditions of payment. There is no requirement for a referral to visit a specialist. Your monthly premiums will typically be lower than other non-network plans such as Medicare Supplement Insurance plans.
Overview of UnitedHealthcare Medicare Advantage
United Healthcare offers a few different types of Medicare Part C plans. The company has designated plans for budgets with minimal healthcare costs. It also offers plans that are being used consistently for inpatient visits. In addition, there are plans specifically for those who need lower deductibles on prescription drugs.
Getting Medicare with United Healthcare
UnitedHealthcare offers plans in most states for a very low or zero-cost monthly premium. You will still have to pay your monthly premium for Part B, but you won’t have to pay to get coverage through United Healthcare. You can pick Medicare Advantage plans, Medicare supplemental plans and Medicare prescription drug plans through an online marketplace on UnitedHealthSolutions.com. Because different plans are available in specific areas, you will need to enter your ZIP code to see what’s available.
Benefits and Costs of United Healthcare Medicare
Most of the benefits for UHC coverage remain the same across different plans, but copays and coverage for prescription drugs change. Each plan includes services for Part A and Part B. However, United Healthcare does a great job of adding discounts for dental, hearing, vision and wellness.
These benefits include the following:
- Inpatient hospital services
- Skilled nursing facility
- Home healthcare
- Chiropractic services
- Outpatient mental healthcare
- Ambulance services
- Emergency care
- Outpatient rehabilitation services
- Alternative medicine
- Discounts for dental, vision and hearing services
- Fitness program
- 24-hour nurse help line
- Worldwide emergency care
- UnitedHealth Passport program
- Health screenings and preventive services
The extra services for Medicare Advantage with United Health are particularly important to customers. With the United Health Passport program, you’re covered for certain medical costs while traveling out of network, even when you go out of the country. You also receive low copays for hearing aids from HealthInnovations.
United Healthcare Plans AARP
Supplemental Medicare Advantage Plans provided through AARP
Health Maintenance Organization (HMO) Plans
- You must obtain healthcare services from a network approved by the plan, which are normally limited to your local area.
- Emergency room, urgent care and dialysis services do not have to be provided by local providers.
- Most plans require referrals from your primary care physician in order to visit a specialist.
Out-of-pocket costs are usually lower than they are with PPO and POS plans.
Point-Of-Service (POS) Plans
- Much like HMO plans except you can see providers for some services that are outside the regular network.
- Seeing providers outside the network may cost more than those inside the network.
- Some plans will require a referral from your primary care physician in order for you to see a specialist.
- Your out-of-pocket costs will probably be higher than with an HMO but less than PPO plans.
Preferred Provider (PPO) Plan
- You are not limited to providers within a network, but costs could be higher outside the network.
- You are not required to obtain a referral from your primary care physician to see a specialist.
- Out-of-pocket costs are typically highest with a PPO plan.
Additional Benefits
- Many plans start with $0 monthly premiums when used in conjunction with your Medicare Part B premium.
- There is a maximum yearly limit on expenses.
- There are fixed annual co-pays for many services, including doctor visits.
- Many preventive services are provided with no copay.
- You have worldwide emergency care coverage.
- There is a 24-hour nurse hotline.
- Annual eye examinations are included.
Optional Coverage at Additional Cost
There are additional coverage options available through AARP as well, although many of them require an additional premium. These include:
- Annual hearing examination
- Hearing aid benefits
- Name brand and generic prescription drug plans similar to Medicare Part D
- Preventive medicine wellness programs
- Routine eyeglasses
There may also be some benefits available that Medicare does not cover.
Standalone United Healthcare prescription drug plans
It’s also possible to purchase drug coverage that is similar to Medicare Part D offered through UnitedHealthcare or one of the company’s affiliates. There are three programs, including AARP MedicareRx Walgreens, AARP Medicare Rx Saver Plus, and AARP MedicareRx Preferred. All three plans require you to pay no more than 51 percent of the total cost of generic drugs or 40 percent of the cost of name-brand drugs in any drug tier during the coverage gap. This is standard for 2017 as part of the Affordable Care Act’s efforts to ease the burden of drug costs in the Medicare donut hole.
AARP MedicareRx Walgreens
The AARP MedicareRx Walgreens prescription drug is a good plan if you want a low premium and can fill prescriptions at a Walgreens location. The benefits include:
- A $0 deductible for Drug Tiers 1-2/$400 for Drug Tiers 3-4
- Most generic drugs covered by Medicare Part D
- Co-pays as low as low as $0 if you fill your prescriptions at Walgreens
Optimum Rx Home Delivery allows you to pay $0 copay for a 90-day supply of Tier 1 medications, which are typically generic drugs. The $0 copay is for Tier 1 medications during the initial coverage phase. It may not apply during the coverage gap and does not apply during the catastrophic stage.
AARP MedicareRx Preferred
If you’re looking for a plan with better drug coverage but still need good value, you’ll like the AARP MedicareRx Preferred prescription drug plan. Benefits include:
- A $0 annual deductible
- Most generic and many commonly used brand-name drugs covered by Medicare Part D
- Co-pays as low as $2 when prescriptions are filled at a Preferred Retail Network Pharmacy
Home delivery includes $0 co-pay for a 90-day supply of Tier 1 and Tier 2 medications. A $0 co-pay is applicable for Tier 1 and Tier 2 medications during the initial coverage phase and may not apply during coverage gap. It does not apply at the catastrophic stage.
AARP MedicareRx Saver Plus
If you need coverage for prescriptions that are most commonly used, you’ll benefit from the AARP MedicareRx Saver Plus prescription drug plan. Benefits include:
- A $400 annual deductible
- Most generic and many commonly used brand-name drugs are included
- Co-pays are as low as $1 when filled at a Preferred Retail Network pharmacy
Unitedhealthcare Chiropractic Copay
Home delivery includes $0 co-pay for a 90-day supply of Tier 1 and Tier 2 medications. A $0 co-pay is applicable for Tier 1 and Tier 2 medications during the initial coverage phase and may not apply during coverage gap. It does not apply at the catastrophic stage.
Other plans under United Health
United Healthcare also has two other types of plans: Medicare Supplemental Insurance and Medicare Special Needs Plans. Supplemental insurance is just for those who have a coverage gap and are using original Medicare. These are Medigap policies that help you take care of out-of-pocket costs, like copays and coinsurance.
You may qualify for Special Needs Plans (SNPs) under Medicare. United Healthcare has a few different plans if you’re eligible to receive benefits through this supplemental plan. These plans are both PPOs, which allow you to see doctors both in and out of the UHC network. Both plans include prescription drug coverage.
United Healthcare Medicare Rating
In 2015, United Healthcare had some issues with some of the doctors in its network. The company removed thousands of doctors who received bad ratings during the Medicare Program review. Plan ratings depend on region. In 2016, the CMS released its ratings for UHC, and the company projected that 84 percent of its members would be enrolled in 4-star plans for the 2017 plan year. The company also noted that 99 percent of its group members would remain in 4-star plans for the same year.
There are a variety of plans and lots of different standalone supplemental plans available with UHC. As such, United Healthcare Medicare Advantage is one of the leading choices for people who are eligible for original Medicare, but want or need more services. Extra services allow you to really take healthcare anywhere you want to go. You also get some great extras, like fitness memberships, hearing aids and prescription drug coverage.
United Healthcare also provides a ton of information on its site for those interested in learning about how Medicare works and what Medicare Advantage is. The site gives you a visual walkthrough of the different plans. You can also learn about different supplemental coverage policies that can help you fill in coverage gaps if you want to keep your original Medicare plan.
It’s clear that United Healthcare doesn’t include every detail of their plans online, but you’ll still get a good idea of what each plan offers. In addition, you can compare the different plans to one another to make the best choice for your medical needs and budget.
United Healthcare Waiver Of Copay
United Healthcare also has a large network of healthcare providers, hospitals and pharmacies. This means that you can save a lot of money by choosing the HMO option for your Medicare Advantage plan. It’s best to compare each plan based on how the copays are distributed. If you can pay zero or low amounts monthly and annually, then you should check to see how much the copay is before you sign up for a Medicare Part C plan. UHC has a variety of plans that balance out the costs, making it easier to visit a doctor when you need to.
United Healthcare Specialist Copay Card
*Star Rating
The star rating listed above is reflective of results of consumer polling from individuals who have used in the past and or currently use that carriers medicare plan. These do not reflect star ratings that have been assigned to each individual carriers plan by CMS. For detailed information about each plans CMS star rating please visit Medicare.gov.