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2020 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)


2020 Medicare Advantage Plan Details
Medicare Plan Name:UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
Location:Miami-Dade, Florida
Plan ID:R0759 - 003 - 0     Click to see other plans
Member Services:1-800-643-4845
— Enrollment Options —
Medicare Contact Information:1-800-MEDICARE (1-800-633-4227)
TTY users 1-877-486-2048
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Email a copy of the UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below)
Annual Deductible:$0 for people who qualify for both Medicare and Medicaid.
Annual Initial Coverage Limit (ICL):$4,020
Health Plan Type:Regional PPO
Special Needs Plan (SNP)
Eligibility Requirement:
Dual-Eligible
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,606 drugsBrowse the UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) Formulary
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:
15%15%15%15%15%
Number of Drugs per
  Tier:
3026868641002752
Plan Offers Mail Order?Yes
Number of Members enrolled in this plan in Miami-Dade, Florida:932 members
Number of Members enrolled in this plan in (R0759 - 003):74,503 members
Plan’s Summary Star Rating: 3.5 out of 5 Stars.
Customer Service Rating: 5 out of 5 Stars.
Member Experience Rating: 3 out of 5 Stars.
Drug Cost Accuracy Rating: 4 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows:
Total
Premium
Part C
Premium
Part D Base
Premium
Part D Supplemental
Premium
$28.10$0.00$28.10$0.00
Monthly Premium with Extra Help Low-Income Subsidy (LIS):100%
Subsidy
75%
Subsidy
50%
Subsidy
25%
Subsidy
Monthly Part D Premium with LIS:$0.00$7.00$14.00$21.10
Total Monthly Premium with LIS (Parts C & D):$0.00$7.00$14.00$21.10
— Plan Health Benefits —
** Base Plan **
Premium Total monthly premium: $28.10
  Health plan premium: $0.00
  Drug plan premium: $28.10
  Standard Part B premium: $135.50
  Part B premium reduction: No
Deductible Health plan deductible: Coming soon
  Drug plan deductible: $435.00
Estimated yearly costs Estimated total yearly costs for care: $0.00
Out-of-pocket max Out-of-pocket max: $10,000 In and Out-of-network $6,700 In-network
Doctor services Primary doctor visit: In-network: $0 copay Out-of-network: 40% per visit
  Specialist visit: In-network: 0% or 20% per visit Out-of-network: 40% per visit
Tests, labs, & imaging Diagnostic tests & procedures: In-network: 0% or 20% Out-of-network: 40%
  Lab services: In-network: $0 Out-of-network: $0 copay
  Diagnostic radiology services (like MRI): In-network: 0% or 20% Out-of-network: 40%
  Outpatient x-rays: In-network: 0% or 20% Out-of-network: 40%
  Emergency care: $0 or $90 per visit (always covered)
  Urgent care: $0 or $65 per visit (always covered)
Hospital services Inpatient hospital coverage: In-network: $0 or $1,300 per stay $0 per day for days 91 and beyond Out-of-network: 40% per stay
  Outpatient hospital coverage: In-network: 0% or 0-20% per visit Out-of-network: 40% per visit
Skilled nursing facility Skilled nursing facility: In-network: Coming soon Out-of-network: 40% per stay
Preventive services Preventive services: In-network: $0 copay Out-of-network: 0-40%
Ambulance Ground ambulance: In-network: 0% or 20% Out-of-network: 20%
Therapy services Occupational therapy visit: In-network: 0% or 20% Out-of-network: 40%
  Physical therapy & speech & language therapy visit: In-network: 0% or 20% Out-of-network: 40%
Mental health services Outpatient group therapy with a psychiatrist: In-network: 0% or 20% Out-of-network: 40%
  Outpatient individual therapy with a psychiatrist: In-network: 0% or 20% Out-of-network: 40%
  Outpatient group therapy visit: In-network: 0% or 20% Out-of-network: 40%
  Outpatient individual therapy visit: In-network: 0% or 20% Out-of-network: 40%
Opioid treatment services Opioid treatment services: Covered
Other services Durable medical equipment (like wheelchairs & oxygen): In-network: 0% or 20% per item Out-of-network: 40% per item
  Prosthetics (like braces, artificial limbs): In-network: 0% or 20% per item Out-of-network: 40% per item
  Diabetes supplies: In-network: $0 per item Out-of-network: 40% per item
Hearing Hearing exam: In-network: $0 copay Out-of-network: 40%
  Fitting/evaluation: Not covered
  Hearing aids - All types: In-network: $0 copay Out-of-network: $0 copay
Preventive dental Oral exam: In-network: $0 copay Out-of-network: $0 copay
  Cleaning: In-network: $0 copay Out-of-network: $0 copay
  Fluoride treatment: In-network: $0 copay Out-of-network: $0 copay
  Dental x-rays: In-network: $0 copay Out-of-network: $0 copay
Comprehensive dental Non-routine services: In-network: $0 Out-of-network: $0 copay
  Diagnostic services: Not covered
  Restorative services: In-network: $0 Out-of-network: $0 copay
  Endodontics: In-network: $0 Out-of-network: $0 copay
  Periodontics: In-network: $0 Out-of-network: $0 copay
  Extractions: In-network: $0 Out-of-network: $0 copay
  Prosthodontics, other oral/maxillofacial surgery, other services: In-network: $0 Out-of-network: $0 copay
Vision Routine eye exam: In-network: $0 Out-of-network: 40%
  Contact lenses: In-network: $0 copay Out-of-network: $0 copay
  Eyeglasses (frames & lenses): In-network: $0 copay Out-of-network: $0 copay
  Eyeglass frames (only): Not covered
  Eyeglass lenses (only): Not covered
  Upgrades: Not covered
More benefits Fitness benefit: Not covered
  Transportation services for non-emergency care: Any health-related locations: Not covered
  Transportation services for non-emergency care: Plan-approved locations: Limited coverage
  Over the counter drug benefits: Limited coverage
  In-home support services: Not covered
  Routine chiropractic service: Limited coverage
  Home and bathroom safety devices: Not covered
  Meals for short duration: Limited coverage
  Annual physical exams: Limited coverage
  Telehealth: Limited coverage
Part B drugs Chemotherapy drugs: In-network: 0% or 20% Out-of-network: 40%
  Other Part B drugs: In-network: 0% or 20% Out-of-network: 40%


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