Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • Home
  • Contact
  • MAPD
  • PDP
  • 2020
  • FAQs
  • Articles
  • Search
  • Contact
  • 2020
  • FAQs
  • Articles
  • Latest Medicare News
  • Search


2020 Medicare Advantage Plan Benefit Details for the Care Improvement Plus Medicare Advantage (Regional PPO)


2020 Medicare Advantage Plan Details
Medicare Plan Name:UnitedHealthcare Medicare Advantage Choice Plan 2 (Regional PPO)
Location:Johnson, Missouri
Plan ID:R3444 - 012 - 0     Click to see other plans
Member Services:1-800-204-1002 TTY users 711
— Enrollment Options —
Medicare Contact Information:1-800-MEDICARE (1-800-633-4227)
TTY users 1-877-486-2048
Advertisement
Medicare plan advice at no cost from licensed insurance agents.  Call: 888-205-9813 / TTY 711
Monday-Friday, 8am-9pm   Weekends, 9am-6pm ET

Email a copy of the UnitedHealthcare Medicare Advantage Choice Plan 2 (Regional PPO) benefit details
— Medicare Plan Features —
Monthly Premium:$48.00 (see Plan Premium Details below)
Annual Deductible:$295 (Tier 1 and 2 excluded from the Deductible.)
Annual Initial Coverage Limit (ICL):$4,020
Health Plan Type:Regional PPO
Maximum Out-of-Pocket Limit for Parts A & B (MOOP):$6,700
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,601 drugsBrowse the UnitedHealthcare Medicare Advantage Choice Plan 2 (Regional PPO) 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:
$4.00$15.00$47.00$100.0027%
Number of Drugs per
  Tier:
3026888591006746
Plan's Pharmacy Search:http://www.UHCMedicareSolutions.com
Plan Offers Mail Order?Yes
Number of Members enrolled in this plan in Johnson, Missouri:82 members
Number of Members enrolled in this plan in Missouri:16,136 members
Plan’s Summary Star Rating: 3.5 out of 5 Stars.
Customer Service Rating: 5 out of 5 Stars.
Member Experience Rating: 4 out of 5 Stars.
Drug Cost Accuracy Rating: 3 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
$48.00$15.80$32.20$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:$4.80$11.70$18.50$25.40
Total Monthly Premium with LIS (Parts C & D):$20.60$27.50$34.30$41.20
— Plan Health Benefits —
** Base Plan **
Premium Total monthly premium: $48.00
  Health plan premium: $15.80
  Drug plan premium: $32.20
  Standard Part B premium: $135.50
  Part B premium reduction: No
Deductible Health plan deductible: $0
  Drug plan deductible: $295.00
Estimated yearly costs Estimated total yearly costs for care: $4,818.00
Out-of-pocket max Out-of-pocket max: $6,700 In and Out-of-network $6,700 In-network
Doctor services Primary doctor visit: In-network: $10 per visit Out-of-network: $25-50 per visit
  Specialist visit: In-network: $50 per visit Out-of-network: $50 per visit
Tests, labs, & imaging Diagnostic tests & procedures: In-network: $20 Out-of-network: $20
  Lab services: In-network: $10 Out-of-network: $10-14
  Diagnostic radiology services (like MRI): In-network: $0-125 Out-of-network: $0-125
  Outpatient x-rays: In-network: $14 Out-of-network: $10-14
  Emergency care: $90 per visit (always covered)
  Urgent care: $30-40 per visit (always covered)
Hospital services Inpatient hospital coverage: In-network: $370 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond Out-of-network: $370 per day for days 1 through 5 $0 per day for days 6 and beyond
  Outpatient hospital coverage: In-network: $0-370 per visit Out-of-network: $0-370 per visit
Skilled nursing facility Skilled nursing facility: In-network: $0 per day for days 1 through 20 $160 per day for days 21 through 62 $0 per day for days 63 through 100 Out-of-network: $175 per day for days 1 through 37 $0 per day for days 38 through 100
Preventive services Preventive services: In-network: $0 copay Out-of-network: $0 copay
Ambulance Ground ambulance: In-network: $250 Out-of-network: $250
Therapy services Occupational therapy visit: In-network: $40 Out-of-network: $40
  Physical therapy & speech & language therapy visit: In-network: $40 Out-of-network: $40
Mental health services Outpatient group therapy with a psychiatrist: In-network: $30 Out-of-network: $30-40
  Outpatient individual therapy with a psychiatrist: In-network: $40 Out-of-network: $30-40
  Outpatient group therapy visit: In-network: $30 Out-of-network: $30-40
  Outpatient individual therapy visit: In-network: $40 Out-of-network: $30-40
Opioid treatment services Opioid treatment services: Covered
Other services Durable medical equipment (like wheelchairs & oxygen): In-network: 20% per item Out-of-network: 45% per item
  Prosthetics (like braces, artificial limbs): In-network: 20% per item Out-of-network: 20% per item
  Diabetes supplies: In-network: $0 per item Out-of-network: 20% per item
Hearing Hearing exam: In-network: $0 copay Out-of-network: $50
  Fitting/evaluation: Not covered
  Hearing aids - All types: In-network: $375-2,075 Out-of-network: $375
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: Not covered
  Diagnostic services: Not covered
  Restorative services: Not covered
  Endodontics: Not covered
  Periodontics: Not covered
  Extractions: Not covered
  Prosthodontics, other oral/maxillofacial surgery, other services: Not covered
Vision Routine eye exam: In-network: $0 copay Out-of-network: $20
  Contact lenses: In-network: $0 copay Out-of-network: 50%
  Eyeglasses (frames & lenses): In-network: $0 copay Out-of-network: 50%
  Eyeglass frames (only): Not covered
  Eyeglass lenses (only): Not covered
  Upgrades: Not covered
More benefits Over the counter drug benefits: Not covered
  Meals for short duration: Not covered
  Annual physical exams: Limited coverage
  Telehealth: Limited coverage
Part B drugs Chemotherapy drugs: In-network: 20% Out-of-network: 20%
  Other Part B drugs: In-network: 20% Out-of-network: 20%
Optional Packages Package #1 Includes preventive dental services, and comprehensive dental services: Monthly premium: $38.00, Deductible: N/A




Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.