United Healthcare Therapy Copay



Urgent care copay rates (Care for minor illnesses and injuries) There's no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, you must: Be enrolled in the VA health care system, and; Have received care from us within the past 24 months (2 years). If you have special health care needs, you can count on us. Our plan will provide the extra care and services needed. Benefits include: Mental Health. Counseling and other treatments are covered. Case Management. If you qualify, get personal help managing health conditions. Asthma and COPD Care. Exams, testing and supplies are covered. UnitedHealthcare's home for Care Provider information with 24/7 access to Link self-service tools, medical policies, news bulletins, and great resources to support administrative tasks including eligibility, claims and prior authorizations. At UnitedHealthcare, we are committed to improving the health care system. UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in. Learn the differences between high and low deductible health insurance plans and what the benefits are so that you can make a more informed decision.


UnitedHealthcare Medicare Advantage Plan 2 (HMO) H0755-031 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by UnitedHealthcare available to residents in Connecticut. This plan includes additional Medicare prescription drug (Part-D) coverage. The UnitedHealthcare Medicare Advantage Plan 2 (HMO) has a monthly premium of $29.00 and has an in-network Maximum Out-of-Pocket limit of $6,000 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,000 out of pocket. This can be a extremely nice safety net.

UnitedHealthcare Medicare Advantage Plan 2 (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.

UnitedHealthcare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for UnitedHealthcare Medicare Advantage Plan 2 (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from UnitedHealthcare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.

Urgent Care Copay United Healthcare



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2020 UnitedHealthcare Medicare Advantage Plan Details

Name:
ID:
H0755-031
Provider:UnitedHealthcare
Year:2020
Type: Local HMO
Monthly Premium C+D: $29.00
Part C Premium:$10.80
MOOP: $6,000
Part D (Drug) Premium:$18.20
Part D Supplemental Premium$0.00
Total Part D Premium:$18.20
Drug Deductible:$150.00
Tiers with No Deductible:1
Gap Coverage:No
Benchmark:not below the regional benchmark
Type of Medicare Health:Enhanced Alternative
Drug Benefit Type:Enhanced

Part-C Premium

UnitedHealthcare plan charges a $10.80 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.


Part-D Deductible and Premium

UnitedHealthcare Medicare Advantage Plan 2 (HMO) has a monthly drug premium of $18.20 and a $150.00 drug deductible. This UnitedHealthcare plan offers a $18.20 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by UnitedHealthcare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $18.20. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.


Premium Assistance

Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The UnitedHealthcare Medicare Advantage Plan 2 (HMO) medicare insurance offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.50 for 75% low income subsidy $9.10 for 50% and $13.60 for 25%.


Full LIS Premium:$0.00
75% LIS Premium:$4.50
50% LIS Premium:$9.10
25% LIS Premium:$13.60

Gap Coverage

In 2020 once you and your plan provider have spent $4020 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This UnitedHealthcare plan does not offer additional coverage through the gap.


UnitedHealthcare Drug Coverage and Formulary

A formulary is divided into tiers or levels of coverage based on the type or usage of your medication or benefit categories, according to drug costs. Each tier will have a defined out-of-pocket cost that you must pay before receiving the drug. You can see complete 2020 UnitedHealthcare Medicare Advantage Plan 2 (HMO) H0755-031 Formulary here.


See the 2020 UnitedHealthcare Formulary


2019 Plan Services

(*2020 Plan services will be added when available)



Health plan deductible


$0


Emergency care/Urgent care


Emergency$90 per visit (always covered)
Urgent care$25-35 per visit (always covered)


Diagnostic procedures/lab services/imaging


Diagnostic tests and procedures20%
Lab services$10
Diagnostic radiology services (e.g., MRI)20%
Outpatient x-rays$14


Hearing


Hearing exam$10
Fitting/evaluationNot covered
Hearing aids$300-2,025

United Healthcare Therapy Copay

Preventive dental


Oral exam$0 copay
Cleaning$0 copay
Fluoride treatment$0 copay
Dental x-ray(s)$0 copay


Comprehensive dental


Non-routine servicesNot covered
Diagnostic services$0
Restorative services20-50%
EndodonticsNot covered
Periodontics50%
Extractions50%
Prosthodontics, other oral/maxillofacial surgery, other services0-50%


Vision


Routine eye exam$20
OtherNot covered
Contact lenses$0 copay
Eyeglasses (frames and lenses)Not covered
Eyeglass frames$0 copay
Eyeglass lenses$0 copay
UpgradesNot covered


Mental health services


Inpatient hospital - psychiatric$395 per day for days 1 through 4
$0 per day for days 5 through 90
Outpatient group therapy visit with a psychiatrist$15
Outpatient individual therapy visit with a psychiatrist$25
Outpatient group therapy visit$15
Outpatient individual therapy visit$25


Skilled Nursing Facility


$0 per day for days 1 through 20
$160 per day for days 21 through 58
$0 per day for days 5


Rehabilitation services


Occupational therapy visit$40
Physical therapy and speech and language therapy visit$40


Ground ambulance


$250


Other health plan deductibles?


In-NetworkNo


Transportation


Not covered


Foot care (podiatry services)


Foot exams and treatment$40
Routine foot care$40


Medical equipment/supplies


Durable medical equipment (e.g., wheelchairs, oxygen)20% per item
Prosthetics (e.g., braces, artificial limbs)20% per item
Diabetes supplies$0 per item


Wellness programs (e.g., fitness, nursing hotline)


Covered


Medicare Part B drugs


Chemotherapy20%
Other Part B drugs20%


Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)


$6,000 In-network


Optional supplemental benefits


No


Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?


In-NetworkNo


Inpatient hospital coverage

Will United Healthcare Cover Therapy


$395 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 91

United Health Care Copay Information


Outpatient hospital coverage


$300 per visit


Doctor visits


Primary$10 per visit
Specialist$40 per visit


Preventive care


$0 copay

Ratings for UnitedHealthcare Medicare Advantage Plan 2 (HMO) H0755

2019 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing

Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment

Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Plan All-Cause Readmissions
Statin Therapy

Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination

Member Complaints and Changes in UnitedHealthcare Medicare Advantage Plan 2 (HMO) Plans Performance

Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement

Health Plan Customer Service Rating for UnitedHealthcare Medicare Advantage Plan 2 (HMO)

United Healthcare Physical Therapy Copay

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language

UnitedHealthcare Medicare Advantage Plan 2 (HMO) Drug Plan Customer Service ratings

Total Rating
Call Center, TTY, Foreign Language
Appeals Auto
Appeals Upheld

Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement

Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs

Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes


Ready to Enroll?


Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST



Coverage Area for UnitedHealthcare Medicare Advantage Plan 2 (HMO)

(Click county to compare all available Advantage plans)

State:Connecticut
County:Fairfield, Hartford, Litchfield, Middlesex, New Haven,
New London, Tolland, Windham,

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Source: CMS.
Data as of September 4, 2019.
Star Rating as of October 10, 2019.
Plan Services are 2019 information as reference. 2020 information will be added when released.
Notes: Data are subject to change as contracts are finalized. For 2020, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2020 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.