Medicare Advantage Plan Benefit Details in Plain Text | |||||||||||||||||||||||||||
The following Medicare Advantage plan benefits apply to the UnitedHealthcare Nursing Home Plan (HMO SNP) (H5253 - 042) in Alamance, North Carolina . This plan is administered by UNITEDHEALTHCARE OF WISCONSIN, INC.. To switch to a different Medicare Advantage plan or to change your location, click here. | |||||||||||||||||||||||||||
Click here to see the UnitedHealthcare Nursing Home Plan (HMO SNP) health and prescription benefit details in chart format
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Plan Premium | |||||||||||||||||||||||||||
The UnitedHealthcare Nursing Home Plan (HMO SNP) has a monthly premium of $31.40. That is $376.80 for 12 months. There are a few factors that can increase or decrease this premium.
If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher.
Please remember that the $31.40 montly premium is in addition to your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA). | |||||||||||||||||||||||||||
This Medicare Advantage Plan with Prescription Drug Coverage is a Local HMO plan. | |||||||||||||||||||||||||||
Plan Membership and Plan Ratings | |||||||||||||||||||||||||||
The UnitedHealthcare Nursing Home Plan (HMO SNP) (H5253 - 042) currently has 2,946 members. , and 1,190 members in North Carolina. | |||||||||||||||||||||||||||
The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as follows:
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Prescription Drug Coverage: Deductible, Cost-sharing, Formulary | |||||||||||||||||||||||||||
This plan has a $400 deductible. So, you are 100% responsible for the first $400 in medication costs. After you have met the deductible, the UnitedHealthcare Nursing Home Plan (HMO SNP) will share the costs of your medications with you -- see cost-sharing below. $400 is the maximum deductible for 2017. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible. | |||||||||||||||||||||||||||
The following information is about the UnitedHealthcare Nursing Home Plan (HMO SNP) formulary (or drug list). There are 3683 drugs on the UnitedHealthcare Nursing Home Plan (HMO SNP) formulary. Click here to browse the UnitedHealthcare Nursing Home Plan (HMO SNP) Formulary. | |||||||||||||||||||||||||||
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $400, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The UnitedHealthcare Nursing Home Plan (HMO SNP)’s formulary is divided into tiers. Every plan can name their tiers differently, and can place medications on any tier. The Tier Cost-sharing data is not yet available. Click here to browse the UnitedHealthcare Nursing Home Plan (HMO SNP) Formulary. | |||||||||||||||||||||||||||
The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where
you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 49% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug manufacturer will pay 50% and your plan will pay an additional 10% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 60% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (UnitedHealthcare Nursing Home Plan (HMO SNP)) offers No Coverage during the Coverage Gap phase. | |||||||||||||||||||||||||||
The UnitedHealthcare Nursing Home Plan (HMO SNP) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail. | |||||||||||||||||||||||||||
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