UHC Complete Care Support IL-1A (PPO C-SNP) (2024)

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Disclaimer information
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Enrollment Disclaimer Information:
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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare. UnitedHealthcare Insurance Company paid royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll. AARP encourages you to consider your needs when selecting products and does not make specific product or pharmacy recommendations for individuals. UnitedHealthcare contracts directly with Walgreens for this plan; AARP and its affiliates are not parties to that contractual relationship.

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Marketing Bullets:

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- Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

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-Nurse Hotline not for use in emergencies, for informational purposes only.

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-Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider.

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-For Chronic Special Needs Plans - You will pay a maximum of $25 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.

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-For All Other Plans - You will pay a maximum of $35 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.

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-Food, OTC and utility benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.

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- Eligibility for the healthy food and utilities benefit under the Value-Based Insurance Design model is limited to members with Extra Help from Medicare and will be determined after enrollment.

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- For C-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. Contact us for details.

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- For D-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as high blood pressure, high cholesterol, chronic and disabling mental health conditions, diabetes and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. There may be other qualified conditions not listed. Contact us for details.

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-You must have a working landline and/or cellular phone coverage to use PERS.

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-The fitness benefit includes a standard fitness membership. The information provided is for informational purposes only and is not medical advice. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine. Gym network may vary in local market and plan.

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-If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. Network size varies by local market.

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-Routine transportation not for use in emergencies.

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-Virtual visits may require video-enabled smartphone or other device. Not for use in emergencies. Not all network providers offer virtual care.

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- $0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the coverage gap or catastrophic stage. Optum® Home Delivery Pharmacy and Optum Rx are affiliates of the UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for medications you take regularly. There may be other pharmacies in your network.

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Other Languages:
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This information is available for free in other languages. PleasecontactCustomer Service for additional information. 

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Esta información está disponible sin costo en otros idiomas. Para obtener más informacióncomuníquesecon nuestro Servicio al Cliente. 
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本資訊可以其他語言免費提供。如需更多資訊,請聯絡客戶服務部。 
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Footnotes

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1Savings benefit
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Savings apply during the Initial Coverage period, which begins after the payment of your required deductible (if any) and ends when the total cost of your drugs (paid by UnitedHealthcare, you and others) reaches $5,030 (2024).

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Optum Home Delivery Pharmacy and Optum Rx are affiliates of UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for your regular medication. There may be other pharmacies in our network. If you have not used Optum Home Delivery Pharmacy, you must approve the first prescription order sent directly from your doctor before it can be filled. New prescriptions from the pharmacy should arrive within ten business days from the date the completed order is received, and refill orders should arrive in about seven business days. Contact Optum Home Delivery Pharmacy anytime at 1-877-266-4832 / TTY 711, 8 a.m. to 8 p.m., 7 days a week.

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$0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the coverage or catastrophic stage. Benefits vary by plan/area. Limitations and exclusions apply.

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Disclaimer information
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D-SNP Disclaimer, State-Level Medicare:
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D-SNP and C-SNP:The values shown in-network represent a range based upon the amount of the Medicare Parts A and B plan cost sharing covered by the state. Depending on your Medicaid eligibility, your Medicaid program may have cost sharing. For complete information, and for costs for those without Medicare Parts A and B plan cost sharing covered by the state, and applicable Medicaid cost sharing, please refer to your Summary of Benefits or Evidence of Coverage. Limitations, exclusions, and restrictions may apply.

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Enrollment Disclaimer Information:
\n

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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare. UnitedHealthcare Insurance Company paid royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll. AARP encourages you to consider your needs when selecting products and does not make specific product or pharmacy recommendations for individuals. UnitedHealthcare contracts directly with Walgreens for this plan; AARP and its affiliates are not parties to that contractual relationship.

\n

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Extra Help:
\n

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If you receive Extra Help from Medicare, your copays may be lower or you may have no copays.

\n

\n

Marketing Bullets:

\n

- Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

\n

\n

-Nurse Hotline not for use in emergencies, for informational purposes only.

\n

\n

-Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider.

\n

\n

-For Chronic Special Needs Plans - You will pay a maximum of $25 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.

\n

\n

-For All Other Plans - You will pay a maximum of $35 for each 1-month supply of Part D covered insulin drug through all coverage stages, except the Catastrophic drug payment stage where you pay $0.

\n

\n

-Food, OTC and utility benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.

\n

\n

- Eligibility for the healthy food and utilities benefit under the Value-Based Insurance Design model is limited to members with Extra Help from Medicare and will be determined after enrollment.

\n

\n

- For C-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. Contact us for details.

\n

\n

- For D-SNP: The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as high blood pressure, high cholesterol, chronic and disabling mental health conditions, diabetes and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. There may be other qualified conditions not listed. Contact us for details.

\n

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-You must have a working landline and/or cellular phone coverage to use PERS.

\n

\n

-The fitness benefit includes a standard fitness membership. The information provided is for informational purposes only and is not medical advice. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine. Gym network may vary in local market and plan.

\n

\n

-If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. Network size varies by local market.

\n

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-Routine transportation not for use in emergencies.

\n

\n

-Virtual visits may require video-enabled smartphone or other device. Not for use in emergencies. Not all network providers offer virtual care.

\n

\n

- $0 copays may be restricted to preferred home delivery prescriptions during the initial coverage phase and may not apply during the coverage gap or catastrophic stage. Optum® Home Delivery Pharmacy and Optum Rx are affiliates of the UnitedHealthcare Insurance Company. You are not required to use Optum Home Delivery Pharmacy for medications you take regularly. There may be other pharmacies in your network.

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The Medicare Prescription Payment Plan:

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Starting Jan. 1, 2025, if you spend more than $2,000 for covered Part D prescription drugs each year, you may want to participate in the Medicare Prescription Payment Plan. This payment plan spreads your out-of-pocket prescription drug costs over the remainder of the calendar year. Learn more about the Medicare Prescription Payment Plan.
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Out-of-network:
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Out-of-network/non-contracted providers are under no obligation to treat members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

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Other Languages:

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This information is available for free in other languages. Please contact Customer Service for additional information. 

\n

\n

Esta información está disponible sin costo en otros idiomas. Para obtener más informacióncomuniquesecon nuestro Servicio al Cliente. 
\n

\n

\n

本資訊可以其他語言免費提供。如需更多資訊,請聯絡客戶服務部。 
\n

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\n"},"pdp":{"Footnotes":"

Disclaimer information
\n

\n

\n

Enrollment Disclaimer Information:
\n

\n

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare. UnitedHealthcare Insurance Company paid royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll. AARP encourages you to consider your needs when selecting products and does not make specific product or pharmacy recommendations for individuals. UnitedHealthcare contracts directly with Walgreens for this plan; AARP and its affiliates are not parties to that contractual relationship.

\n

\n

Extra Help:
\n

\n

If you receive Extra Help from Medicare, your copays may be lower or you may have no copays.

\n

\n

The Medicare Prescription Payment Plan:
\n

\n

Starting Jan. 1, 2025, if you spend more than $2,000 for covered Part D prescription drugs each year, you may want to participate in the Medicare Prescription Payment Plan. This payment plan spreads your out-of-pocket prescription drug costs over the remainder of the calendar year. Learn more about the Medicare Prescription Payment Plan.
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Other Languages:
\n

\n

This information is available for free in other languages. PleasecontactCustomer Service for additional information. 

\n

\n

Esta información está disponible sin costo en otros idiomas. Para obtener más informacióncomuníquesecon nuestro Servicio al Cliente. 
\n

\n

\n

本資訊可以其他語言免費提供。如需更多資訊,請聯絡客戶服務部。 
\n

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\n"}},"detailContent":{"initialCoverageStage":"Initial Coverage Stage","coveredPharmacyMessage":"The pharmacy you selected provides prescription drug coverage under this plan. For drug pricing at this pharmacy, call UnitedHealthcare:","notCoveredPharmacyMessage":"The pharmacy you selectedis not part of this plan's pharmacy network. To estimate your annual drug costs, you'll need to select a pharmacy that is in this plan's network."},"header":{"printPlanDetails":"Print","primaryCareProvider":"Primary Care Provider","outOfPocketMaximum":"Out-of-pocket maximum","saved":"Saved","addYourDrugs":"Add your drugs","save":"Save","emailPlanDetails":"Email plan details","enroll":"Enroll","estimatedAnnualDrugCost":"Estimated annual drug cost","addPlanToCompare":"Add to compare","monthlyPremium":"Monthly premium"},"cnsPlanListNew":{"master":{"planId":"master","plan-year-and-plan-name":["{\"planyear\":\"\",\"planname\":\"\",\"clientprodcode\":\"\",\"lineofbusiness\":\"\"}","{\"planyear\":\"\",\"planname\":\"\",\"clientprodcode\":\"\",\"lineofbusiness\":\"\"}"]},"h2228041000":{"planId":"H2228041000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete Choice Premier (PPO 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D-SNP)\",\"clientprodcode\":\"402\",\"lineofbusiness\":\"MEDICAID\"}"]},"h4514016000":{"planId":"H4514016000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete Ally (HMO-POS D-SNP)\",\"clientprodcode\":\"\",\"lineofbusiness\":\"MEDICARE\"}","{\"planyear\":\"2024\",\"planname\":\"UHC Dual Complete TX-D01P (HMO-POS D-SNP)\",\"clientprodcode\":\"\",\"lineofbusiness\":\"MEDICARE\"}"]},"h5253024000":{"planId":"H5253024000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)\",\"clientprodcode\":\"421\",\"lineofbusiness\":\"MEDICAID\"}","{\"planyear\":\"2024\",\"planname\":\"UHC Dual Complete WI-D003 (HMO-POS D-SNP)\",\"clientprodcode\":\"421\",\"lineofbusiness\":\"MEDICAID\"}"]},"h5253059000":{"planId":"H5253059000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete LP (HMO-POS 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D-SNP)\",\"clientprodcode\":\"\",\"lineofbusiness\":\"MEDICARE\"}"]},"h3387014002":{"planId":"H3387014002","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete Plan 1 (HMO-POS D-SNP)\",\"clientprodcode\":\"621\",\"lineofbusiness\":\"MEDICAID\"}","{\"planyear\":\"2024\",\"planname\":\"UHC Dual Complete NY-S002 (HMO-POS D-SNP)\",\"clientprodcode\":\"621\",\"lineofbusiness\":\"MEDICAID\"}"]},"h0271044000":{"planId":"H0271044000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete Choice (PPO D-SNP)\",\"clientprodcode\":\"506\",\"lineofbusiness\":\"MEDICAID\"}","{\"planyear\":\"2024\",\"planname\":\"UHC Dual Complete WA-D001 (PPO D-SNP)\",\"clientprodcode\":\"506\",\"lineofbusiness\":\"MEDICAID\"}"]},"h7464005000":{"planId":"H7464005000","plan-year-and-plan-name":["{\"planyear\":\"2023\",\"planname\":\"UnitedHealthcare Dual Complete ONE (HMO-POS 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Find out about this plan's copays for primary care providers and specialists.

\n","accordionName":"Doctor visits"},"plan_documents":{"accordionContent":"

Important documents that provide the details you need about this plan's coverage and benefits, prescription drugs, enrollment, providers and more.

\n","accordionName":"Plan documents"},"dental_coverage":{"accordionContent":"

Learn about this plan's dental coverage options and costs.

\n","accordionName":"Dental coverage"},"retail_network_pharmacy30day":{"accordionName":"Retail network pharmacy (30-day supply)"},"eligibility":{"accordionName":"Eligibility"},"preferred_mail_orderpharmacy100day":{"accordionName":"Preferred mail order pharmacy (100-day supply)"},"medical_benefits":{"accordionContent":"

See this plan's benefits, costs and copays. For full plan details, see the Evidence of Coverage orSummary of Benefits under the Plan Documents section.

\n","accordionName":"Medical benefit information"},"discover_the_benefits":{"accordionName":"Discover the benefits"},"prescription_drugbenefits":{"accordionContent":"

Learn about this plan's prescription drug coverage and costs. Enter your prescriptions to see what they'd cost with this plan.

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See how much you'll pay for this plan including your premium, deductible and maximum out-of-pocket costs.

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See more of the benefits and programs offered by this plan that are not provided under Original Medicare. For full plan details, see the Evidence of Coverage or Summary of Benefits under the Plan Documents section.

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Learn more about what you pay, what this plan covers and how we can help you find the right plan.

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What is an HMO? Medicare Health Maintenance Organization (HMO) plans cover care you receive through a network of local doctors and hospitals that coordinate your care.

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What is PPO? Preferred Provider Organization (PPO) plans allow you to visit providers who are in or out of the plan's network. For services received outside of the network, you generally have higher copayment and coinsurance costs.

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What is HMO-POS? A type of HMO plan, Point of Service (POS) plans let you receive certain services from doctors or hospitals that are not in the plans network, generally at a higher copayment or coinsurance.

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What is PFFS? A Private Fee-for-Service (PFFS) plan is a Medicare Advantage plan that can be a network or non-network plan. UnitedHealthcare only offers non-network PFFS plans, which give members the freedom to use any Medicare-eligible doctor or hospital who agrees to accept the plan's terms and conditions of payment. No referrals or prior authorizations are required for covered services.

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What is an HMO? Medicare Health Maintenance Organization (HMO) plans cover care you receive through a network of local doctors and hospitals that coordinate your care.

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What is PPO? Preferred Provider Organization (PPO) plans allow you to visit providers who are in or out of the plan's network. For services received outside of the network, you generally have higher copayment and coinsurance costs.

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What is HMO-POS? A type of HMO plan, Point of Service (POS) plans let you receive certain services from doctors or hospitals that are not in the plans network, generally at a higher copayment or coinsurance.

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For Chronic Special Needs plans: You will pay a maximum of $25 for each 1-month supply of Part D select insulin drug through all coverage stages. For all other plans: You will pay a maximum of $35 for each 1-month supply of Part D covered insulin drug through all coverage stages.

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UHC Complete Care Support IL-1A (PPO C-SNP)

Monthly premium: $0 - $22.80

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UHC Complete Care Support IL-1A (PPO C-SNP) (3)

  • Monthly premium
  • $0 - $22.80
  • $0 - $22.80
  • Primary care provider (PCP)
  • $0 - 20% of the cost
  • $0 - 20% of the cost
  • Out-of-pocket maximum
  • $0 - $9,350
  • $0 - $9,350
  • Estimated Annual Drug Cost

Discover the Benefits

  • OTC and food credit

  • $217 credit every month to pay for OTC products -- and healthy food for qualifying members in-store or online
  • Dental benefits

  • $3,500 allowance for covered dental services like cleanings, fillings, crowns, root canals, extractions and dentures
  • Routine vision benefits

  • $300 allowance for frames or contacts every year, plus $0 copay for a routine eye exam and standard prescription lenses

Eligibility

Special eligibility requirement Must be diagnosed with diabetes, chronic heart failure, and/or a cardiovascular disorder.
Special eligibility requirement Must be diagnosed with diabetes, chronic heart failure, and/or a cardiovascular disorder.Must be diagnosed with diabetes, chronic heart failure, and/or a cardiovascular disorder.

General plan costs

See how much you'll pay for this plan including your premium, deductible and maximum out-of-pocket costs.

Costs In-network - What you'll pay Out-of-network - What you'll pay
Monthly premium $0 - $22.80
Monthly premium $0 - $22.80$0 - $22.80
Annual medical deductible

UHC Complete Care Support IL-1A (PPO C-SNP) (4) UHC Complete Care Support IL-1A (PPO C-SNP) (5)

Annual medical deductible The pre-set, fixed amount you must pay for health care costs before the insurance company or Medicare begins to pay. Please see your Evidence of Coverage for details. x Close Popup

$0 - $257
These are 2024 Medicare-defined amounts and may change for 2025. combined in and out-of-network
Annual medical deductible

UHC Complete Care Support IL-1A (PPO C-SNP) (6) UHC Complete Care Support IL-1A (PPO C-SNP) (7)

Annual medical deductible The pre-set, fixed amount you must pay for health care costs before the insurance company or Medicare begins to pay. Please see your Evidence of Coverage for details. x Close Popup

$0 - $257
These are 2024 Medicare-defined amounts and may change for 2025. combined in and out-of-network
$0 - $257
These are 2024 Medicare-defined amounts and may change for 2025. combined in and out-of-network
Out-of-pocket maximum

UHC Complete Care Support IL-1A (PPO C-SNP) (8) UHC Complete Care Support IL-1A (PPO C-SNP) (9)

Out-of-pocket maximum This is the highest amount of money you have to pay out of your pocket for cost sharing (copayments and coinsurance) charged for certain covered services during a calendar year. Not all copayments or coinsurance amounts you pay apply toward the annual out-of-pocket maximum. See the plan’s Evidence of Coverage for more information. x Close Popup

$0 - $9,350 $14,000 combined in and out-of-network
Out-of-pocket maximum

UHC Complete Care Support IL-1A (PPO C-SNP) (10) UHC Complete Care Support IL-1A (PPO C-SNP) (11)

Out-of-pocket maximum This is the highest amount of money you have to pay out of your pocket for cost sharing (copayments and coinsurance) charged for certain covered services during a calendar year. Not all copayments or coinsurance amounts you pay apply toward the annual out-of-pocket maximum. See the plan’s Evidence of Coverage for more information. x Close Popup

$0 - $9,350$14,000 combined in and out-of-network
National Network

UHC Complete Care Support IL-1A (PPO C-SNP) (12) UHC Complete Care Support IL-1A (PPO C-SNP) (13)

National Network As a member of an eligible health plan, the UnitedHealthcare Medicare National Network allows you to have access to participating care providers across the United States at your in-network cost share, even when getting care outside of your home location. Networks vary by market and exclusions may apply. x Close Popup

No
National Network

UHC Complete Care Support IL-1A (PPO C-SNP) (14) UHC Complete Care Support IL-1A (PPO C-SNP) (15)

National Network As a member of an eligible health plan, the UnitedHealthcare Medicare National Network allows you to have access to participating care providers across the United States at your in-network cost share, even when getting care outside of your home location. Networks vary by market and exclusions may apply. x Close Popup

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UHC Complete Care Support IL-1A (PPO C-SNP) (16)

UHC Complete Care Support IL-1A (PPO C-SNP) (2024)
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