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UHC Complete Care UT-0006 (HMO-POS C-SNP)

Utah Chronic Condition Special Needs C-SNP Plan (2024 Plan)

Monthly Premium

Your Cost
$0
by UnitedHealthcare®

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.5
out of 5 stars

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Plan Overview

Plan Name
UHC Complete Care UT-0006 (HMO-POS C-SNP)
Insurance Carrier
UnitedHealthcare®
Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Network Type
HMO

UHC Complete Care UT-0006 (HMO-POS C-SNP) is a Chronic Condition Special Needs Plan (C-SNP), which is available in Utah and offered by the health insurance company UnitedHealthcare®. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$4,900
Primary doctor visit
$0 copay
Specialist visit
$0-30 copay per visit
ER visit
$120 copay per visit (always covered)
Ambulance
$290 copay

UHC Complete Care UT-0006 (HMO-POS C-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $4,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for UHC Complete Care UT-0006 (HMO-POS C-SNP) are defined below.

Additional Benefits and Coverage

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

UHC Complete Care UT-0006 (HMO-POS C-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. UHC Complete Care UT-0006 (HMO-POS C-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. UHC Complete Care UT-0006 (HMO-POS C-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of UHC Complete Care (HMO-POS C-SNP) to Other Plans in Utah

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, UHC Complete Care (HMO-POS C-SNP) received an overall government quality rating of 4.5 stars out of 5 stars.

UHC Complete Care (HMO-POS C-SNP) performed better than Utah’s State average overall quality score of 4.2 stars.

This Plan’s 5-star Gov’t Quality Score
Utah State Average Score
Overall Government 5 Star Quality Rating
 4.5
 4.2
Summary rating of health plan quality
 4
 4.1
Staying healthy: screenings, tests, & vaccines
 4
 4.0
Managing chronic (long term) conditions
 4
 3.7
Member experience with health plan
 4
 4.0
Member complaints & changes in the health plan's performance
 4
 4.0
Health plan customer service
 5
 4.5
Summary rating of drug plan quality
 4.5
 3.9
Drug plan customer service
 4
 3.9
Member complaints & changes in the drug plan's performance
 5
 4.5
Member experience with the drug plan
 4
 3.8
Drug safety & accuracy of drug pricing
 4
 3.5

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

UHC Complete Care (HMO-POS C-SNP) received 4 stars for its health plan quality score which is worse than the Utah State average health plan quality score of 4.1 stars.

UHC Complete Care (HMO-POS C-SNP) received 4.5 stars for its drug plan quality score which is better than the Utah State average drug plan quality score of 3.9 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$4,900 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://UHC.com/Medicare
Plan Link
http://UHC.com/Medicare

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: No Data
Specialist visit
In-network: $0-30 copay per visit
Out-of-network: No Data

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: No Data
Lab services
In-network: $0 copay
Out-of-network: No Data
Diagnostic radiology services (like MRI)
In-network: $0-90 copay
Out-of-network: No Data
Outpatient x-rays
In-network: $15 copay
Out-of-network: No Data
Emergency care
$120 copay per visit (always covered)
Urgent care
$0-40 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $290 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: Not Applicable
Outpatient hospital coverage
In-network: $0-290 copay per visit
Out-of-network: No Data

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: No Data

Ambulance

Ground ambulance
In-network: $290 copay
Out-of-network: No Data

Therapy services

Occupational therapy visit
In-network: $0-20 copay
Out-of-network: No Data
Physical therapy & speech & language therapy visit
In-network: $0-20 copay
Out-of-network: No Data

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $15 copay
Out-of-network: No Data
Outpatient individual therapy with a psychiatrist
In-network: $0-25 copay
Out-of-network: No Data
Outpatient group therapy visit
In-network: $15 copay
Out-of-network: No Data
Outpatient individual therapy visit
In-network: $0-25 copay
Out-of-network: No Data

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: No Data
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: No Data
Diabetes supplies
In-network: $0 copay
Out-of-network: No Data

Prescription Drug Benefits

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

TiersInitial coverage phaseGap coverage phase1Catastrophic coverage phase
Preferred Generic$0.00 copay$0.00 copay$0 copay
Generic$10.00 copay$10.00 copay$0 copay
Preferred Brand$45.00 copay$0 copay
Non-Preferred Drug$95.00 copay$0 copay
Specialty Tier33%$0 copay
1 * The above cost-sharing only applies to some drugs on this tier. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: No Data
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: No Data

Extra Benefits

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: No Data
Fitting/evaluation
Not covered
Hearing aids - All types
In-network: $99-1,249 copay
Out-of-network: No Data

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 copay
Out-of-network: 0-50% coinsurance
Diagnostic services
In-network: $0 copay
Out-of-network: 0-50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 0-50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 0-50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 0-50% coinsurance
Extractions
In-network: $0 copay
Out-of-network: 0-50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: 0-50% coinsurance
Out-of-network: 0-50% coinsurance

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: No Data
Contact lenses
In-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
Not covered

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