Your plan details for
34109 Collier County

UHC Dual Complete FL-D003 (PPO D-SNP) H1889-002-002

The information provided in this document may be subject to change over time and may become outdated. For the most current and up-to-date information, please refer to our website at UHC.com/medicare.

Discover the benefits

  • OTC, food and utilities

    $215 credit every month to pay for OTC products, healthy food and utility bills

  • Dental benefits

    $2,750 allowance for covered preventive and comprehensive dental services

  • Routine transportation

    $0 copay for 48 one-way rides to or from doctor visits or the pharmacy

Explore the plan details

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Explore the plan details

Eligibility

Special eligibility requirement

Must be eligible for Medicare and have full or partial Medicaid coverage in one of the following categories in FL: FBDE, QI, QMB, QMB PLUS, SLMB, SLMB PLUS.

Doctor visits

Find out about this plan’s copays for primary care providers and specialists.

Primary care provider (PCP)

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Specialist

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Virtual visits

$0 copay to talk with a network telehealth provider online through live audio and video.

Annual routine physical

$0 copay 1 per year
In-network
40% of the cost combined visits in and out-of-network

Preventive services (such as covered screenings, vaccinations, etc.)

$0 copay for covered services
In-network
$0 - 40% of the cost (depending on the service)
Out-of-network

Mental health (outpatient)

Group: $0 - 20% of the costIndividual: $0 - 20% of the cost
In-network
Group: 40% of the costIndividual: 40% of the cost
Out-of-network

Opioid treatment services

$0 copay
In-network
$0 copay
Out-of-network

Medical benefit information

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

Inpatient hospital care

$0 copay with full Medicaid or if you are a Qualified Medicare Beneficiary, otherwise:$0 - $1,580 per stay for unlimited days
In-network
40% per stay for unlimited days
Out-of-network

Skilled nursing facility

$0 copay with full Medicaid or you are a Qualified Medicare Beneficiary, otherwise:$0 copay per day: days 1-20$209.50 copay per day: days 21-100
In-network
40% of the cost
Out-of-network

Outpatient hospital services (including surgery and observation)

$0 - 20% of the cost
In-network
$0 - 40% of the cost
Out-of-network

Ambulatory surgical center

$0 copay - 20% of the cost
In-network
$0 copay - 40% of the cost
Out-of-network

Physical and speech therapy

$0 - 20% of the cost
In-network
$0 - 40% of the cost
Out-of-network

Occupational therapy

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Lab services

$0 copay
In-network
$0 copay
Out-of-network

Outpatient X-rays

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Diagnostic tests and procedures, non-radiological (such as EKG/ECG tests, etc.)

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Diagnostic radiology services (such as MRIs, CT scans, etc.)

$0 - 20% of the cost
In-network
40% of the cost
Out-of-network

Diabetes monitoring supplies

$0 copay for covered brands
In-network
40% of the cost
Out-of-network

Home health care

$0 copay
In-network
$0 copay
Out-of-network

Urgent care

$0 - $45 copay per visit ($0 copay when outside of the United States)

Emergency care

$0 - $110 copay per visit ($0 copay when outside of the United States)

Ambulance services

$0 - 20% of the cost for ground or air

Prescription drug benefits

Learn about this plan's costs for prescription drug coverage.

Annual prescription deductible

$0

Cost shares if you receive Extra Help

Brand Drugs

$0 copay

Generic Drugs

$0 copay

Dental coverage

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

Routine dental

$2,750 per year for covered dental services
$0 copay for covered network preventive services such as oral exams, routine cleanings, X-rays and fluoride
$0 copay for covered network comprehensive services such as fillings, crowns, root canals, extractions, bridges and dentures
You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist. Seeing a network dentist may save you money.

Extra benefits and programs

See more of the benefits and programs offered by this plan that are not provided under Original Medicare.

See the UnitedHealthcare plan difference

Routine eye exam

$0 copay 1 per year
In-network
40% of the cost combined visits in and out-of-network

Routine eyewear

$0 copay every yearPlan pays up to $400 every year for standard lenses/frames and contacts.
In-network
$0 copay every yearPlan pays up to $400 every year for lenses/frames and contacts, combined in and out-of-network.

Hearing sounds better with more access

Routine hearing exam

$0 copay 1 per year
In-network
40% of the cost combined visits in and out-of-network

Hearing aids

$2,200 allowance for a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing, up to 2 hearing aids every year

Get more for your everyday needs

Food, OTC and utility bill credit

$215 credit every month to pay for covered OTC products, covered healthy food and utility bills from network utility companies.

Rewards

Earn up to $165 in rewards every year for getting an annual wellness visit, being physically active, connecting with others and more.

Fitness program

$0 copay for Renew Active®, which includes a free membership at core and premium gyms, plus online fitness classes and brain health challenges.

Routine transportation

$0 copay for 48 one-way trips to or from plan approved locations.
In-network

75% of the cost
Out-of-network

Routine foot care

$0 copay 12 visits per year
In-network
40% of the cost combined visits in and out-of-network

Meal benefit

$0 copay for 28 home-delivered meals immediately after an inpatient hospitalization or skilled nursing facility (SNF) stay.

Routine chiropractic

$0 copay 12 chiropractic visits per year
In-network
40% of the cost combined visits in and out-of-network

Plan documents

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

Language

General Plan Information

Prescription Drug Coverage

Pharmacy Directory

Online Pharmacy Directory Opens in a new tab

Medical Providers

General Plan Information

Prescription Drug Coverage

Pharmacy Directory

Directorio de Farmacias en Internet Opens in a new tab
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Footnotes & disclaimers

footnote
Disclaimer information

 

Enrollment Disclaimer Information:

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and/or Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. For Dual Special Needs Plans: A Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.

 

AARP-related Disclaimer:

UnitedHealthcare Insurance Company pays 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 in a Medicare Advantage or Prescription Drug Plan. AARP encourages you to consider your needs when selecting products and does not make specific product recommendations for individuals. AARP does not employ or endorse agents, producers or brokers.

 

Extra Help: 

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

 

Featured Benefits:

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

 

- Optum HouseCalls may not be available in all areas.

 

- OTC, food, and/or utility benefits have expiration timeframes. Review your Evidence of Coverage (EOC) for more information. The healthy food and utilities benefit is a special supplemental benefit only available to chronically ill enrolles with a qualifying condition, such as diabetes, cardiovascular disorders, chronic heart failure, chronic high blood pressure and/or chronic high cholesterol, and who also meet all applicable plan coverage criteria. There may be other qualified chronic conditions not listed.

 

- The Giveback benefit is a reduction in your Medicare Part B premium.

 

- A 50% coinsurance applies to covered dental comprehensive services. 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.

 

- Reward offerings may vary by plan. Reward program Terms of Service apply.

 

- 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.

 

- Routine transportation not for use in emergencies. A trip is one-way and roundtrip is two trips.

 

- Annual routine eye exam and an allowance for contacts or one pair of frames, with standard (single, bi-focal, tri-focal or standard progressive) lenses covered in full every one or two years. Review your Evidence of Coverage (EOC) for more information.

 

- CareFlex benefit credits can only be used by members of AARP Medicare Advantage CareFlex plans for cost-shares for certain Medicare Parts A and B covered items and services. CareFlex credits are loaded on a Visa debit card. Unused credits will rollover each quarter and expire Dec. 31. Credits not redeemable for cash.

 

- The fitness benefit and gym network varies by plan/area and participating locations may change. The fitness benefit includes a standard fitness membership at participating locations. Not all plans offer access to premium locations. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine.

 

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

 

Out-of-network:

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. 

 

The Medicare Prescription Payment Plan: 

If you have high out-of-pocket costs for your 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.
 

Out-of-network:

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. 

 

State-Level Medicaid, D-SNP Disclaimer:

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.

 

Other Languages:

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

 

Esta información está disponible sin costo en otros idiomas. Para obtener más información comuníquese con nuestro Servicio al Cliente. 

 

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。