AARP MedicareComplete SecureHorizons 2 (HMO)

Medicare Advantage Plan (Part C w/ RX)

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PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
UnitedHealthcare
CMS Rating
Plan Type
HMO
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage
  • This plan is available for 2015. see plan

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • has dental coverage
  • Primary care physician office visit copay of $0
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Plan Details

Costs and Other Important Information

Plan Year:
2013
Optional Supplemental Benefits?
Yes
Choice of Doctors?
Plan Doctors Only
Prescription Drugs Covered?
Yes
Out-Of-Pocket Spending Limit
$3,400 In-Network
Other Deductibles?
In Network: No. Out of Network: No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
In Network
Out of Network
Doctor Office Visits
$0 maximum per visit
Not Applicable
Specialist Office Visit
$0 maximum per visit
Not Applicable
Outpatient Services
$0 maximum per visit
Not Applicable
Emergency Care
$50 maximum per visit
Not Applicable
Ambulance Services
$75 maximum
Not Applicable
Kidney Disease and Conditions
20% maximum per visit
Not Applicable
Home Health Care
$0 maximum per visit
Not Applicable
Durable Medical Equipment
20% maximum per item
Not Applicable
Inpatient Hospital Care
Days 1-90: $0 copay per day
Not Applicable
Skilled Nursing Facility (SNF)
Days 1-20: $0 copay per day. Days 21-88: $50 copay per day. Days 89-100: $0 copay per day
Not Applicable
Inpatient Mental Health Care
Days 1-90: $0 copay per day
Not Applicable

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copayNot offered
Tier 2: Non-Preferred Generic$5 copay$5 copayNot offered
Tier 3: Preferred Brand Name$45 copay$45 copayNot offered
Tier 4: Non-Preferred Brand Name$92 copay$92 copayNot offered
Tier 5: Specialty Tier33% coinsurance33% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copay$0 copay
Tier 2: Non-Preferred Generic$15 copay$15 copay$10 copay
Tier 3: Preferred Brand Name$135 copay$135 copay$125 copay
Tier 4: Non-Preferred Brand Name$276 copay$276 copay$266 copay
Tier 5: Specialty Tier33% coinsurance33% coinsurance33% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Cholesterol screening for patients with heart disease
Glaucoma testing
Annual flu vaccine
Pneumonia vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Access to primary care doctor visits
Adult BMI assessment

Managing Chronic Conditions

Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Diabetes care – cholesterol controlled
Controlling blood pressure
Rheumatoid arthritis management
Improving bladder control
Reducing the risk of falling
Plan all-cause readmissions

Ratings of Plan Responsiveness and Care

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan

Member Complaints, Problems Getting Services, and Choosing to Leave the Plan

Complaints about the health plan
Beneficiary access and performance problems
Members choosing to leave the plan
Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability

Physician Finder

Physicians that accept AARP MedicareComplete SecureHorizons 2 (HMO) for California

/
MULL, JOHN
4425 SOUTH CENTRAL AVE
LOS ANGELES, CA 90011
BAHARI-NEJAD, PEJMAN
4425 S CENTRAL AVE
LOS ANGELES, CA 90011
GILMAN, ELENA
4211 AVALON BLVD
LOS ANGELES, CA 90011
LUCAS, DEBORAH
4211 AVALON BLVD
LOS ANGELES, CA 90011
JEFFERSON, RONALD
4211 AVALON BLVD
LOS ANGELES, CA 90011
KASHANI, HOUMAN
747 WAREHOUSE ST
LOS ANGELES, CA 90021
MHAWECH, PAULETTE
1500 SAN PABLO ST
LOS ANGELES, CA 90033
WONG, MICHAEL
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
PETROVIC, LIDIJA
1510 SAN PABLO ST FL 6
LOS ANGELES, CA 90033
PRESS, MICHAEL
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
EL-KHOUEIRY, ANTHONY
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
YANG, ALLEN
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
DANIELS, JOHN
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
RUSSELL, CHRISTY
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
ATTALLA, RAAFAT
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
BRYNES, RUSSELL
2011 ZONAL AVE
LOS ANGELES, CA 90089
WANG, LINA
1500 SAN PABLO ST
LOS ANGELES, CA 90033
FELIX, JUAN
2011 ZONAL AVE
LOS ANGELES, CA 90089
SHIBATA, DARRYL
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
SHERROD, ANDY
1500 SAN PABLO ST
LOS ANGELES, CA 90033
NICHOLS, PETER
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
MARTIN, SUE
1500 SAN PABLO STREET
LOS ANGELES, CA 90039
MILGROM, ETAN
849 W 34TH ST
LOS ANGELES, CA 90089
LEAVITT, WILLIAM
849 W 34TH ST
LOS ANGELES, CA 90089
LAI, ROSE
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
Details
JOHN MULL, MD MPH
Phone Number
(323) 908-4219
Office Locations
4425 SOUTH CENTRAL AVE
LOS ANGELES, CA 90011
4425 SOUTH CENTRAL AVE LOS ANGELES CA, 90011

Community Q&A

Do you have questions about this plan?

Get answers from the HealthPocket community.
2 question| 1 answer
Dental Coverage
Q:What is the extent of Dental Coverage and costs?
Asked by Stixx 

1 answer

Know the Answer? Answer this Question
A: Hi Stixx. For coverage specific questions, it is best if you contact the insurance provider directly. UnitedHealthcare can be reached at 1-800-547-5514 or by visiting their website (https://www.uhcmedicaresolutions.com). Hope this helps.
Answered on 9/6/2013 by Duncan 
is Long Beach memory hospital include
Q:
Asked by Anonymous 

1 answer

Know the Answer? Answer this Question
A: To find out all facilities available in your area, it is best to contact the insurance provider directly. UnitedHealthcare can be reached at 1-800-547-5514, or at https://www.uhcmedicaresolutions.com/en.html
Answered on 9/6/2013 by Duncan 

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