UnitedHealthcare Dual Complete (HMO D-SNP)

Medicare Plan Details (2022 Plan)


Monthly Premium

 

by UnitedHealthcare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.5
out of 5 stars

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Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D

 

$25
$0
$25
$0 or $203 In-network
$7,550 In-network
No
Yes
Yes
Yes

Doctor Services

$0 copay
0% or 20% coinsurance per visit

Tests, labs, & imaging

0% or 20% coinsurance
$0 copay
0% or 0-20% coinsurance
0% or 20% coinsurance
$0 or $90 copay per visit (always covered)
$0 or $65 copay per visit (always covered)

Hospital Services

$0 or $1,480 per stay
$0 per day for days 91 and beyond
0% or 0-20% coinsurance per visit

Skilled nursing facility

In 2022 the amounts for each benefit period are $0 or:
$0 copay for days 1 through 20
$194.50 copay per day for days 21 through 100

Preventive services

$0 copay

Ambulance

0% or 20% coinsurance

Therapy services

0% or 20% coinsurance
0% or 20% coinsurance

Mental health services

0% or 20% coinsurance
0% or 20% coinsurance
0% or 20% coinsurance
0% or 20% coinsurance

Opioid treatment services

Covered

Other services

0% or 20% coinsurance per item
0% or 20% coinsurance per item
$0 copay per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$3.95 copay or 5% (whichever costs more)

Brand-name drugs :
$9.85 copay or 5% (whichever costs more)

Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

0% or 20% coinsurance
0% or 20% coinsurance

Hearing

$0 copay
Not covered
$0 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Vision

$0 copay
$0 copay
$0 copay
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4.5
 3
 4
 4
 4
 5
 4
 5
 4
 5
 4

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