2019 UnitedHealthcare MedicareComplete Assure (PPO) H0271-8-0 in AZ from UnitedHealthcare | HealthPocket

UnitedHealthcare MedicareComplete Assure (PPO)

$26/mo

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Zip Code85364
Applicant7/21/1984 Male
Coverage Start7/22/2019
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH0271-8-0
Plan Year2019
CMS RatingNot Rated
Plan TypePPO
Annual Deductible$415.00

What To Know About This Plan
  • This plan has health and drug coverage

Why We Like This Plan
  • has both Health and Drug Coverage
  • was the 5th best selling plan in Yuma in 2019

Costs and Other Important Information

Plan Year2019
Monthly Health Plan Premium$0.00
Monthly Drug Plan Premium$26.90
Health Plan Deductible$185 per year for some in-network and out-of-network services.
Other health plan deductibles?No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$10,000 In and Out-of-network
$6,700 In-network
Optional Supplemental BenefitsNo

Benefits

SERVICECOST
Inpatient hospital coverageIn-Network:$1,300 per stay
Out-of-Network:30% per stay
Outpatient hospital coverageIn-Network:20% per visit
Out-of-Network:30% per visit
Doctor visitsPrimary:
In-Network:$0 copay
Out-of-Network:30% per visit
Specialist:
In-Network:20% per visit
Out-of-Network:30% per visit
Preventive careIn-Network:$0 copay
Out-of-Network:0-30%
Emergency care/Urgent careEmergency:$90 per visit (always covered)
Urgent care:$65 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
In-Network:20%
Out-of-Network:30%
Lab services:
In-Network:$0
Out-of-Network:$0 copay
Diagnostic radiology services (e.g., MRI):
In-Network:20%
Out-of-Network:30%
Outpatient x-rays:
In-Network:20%
Out-of-Network:30%
Mental health servicesInpatient hospital - psychiatric:
In-Network:$1,300 per stay
Out-of-Network:30% per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:20%
Out-of-Network:30%
Outpatient individual therapy visit with a psychiatrist:
In-Network:20%
Out-of-Network:30%
Outpatient group therapy visit:
In-Network:20%
Out-of-Network:30%
Outpatient individual therapy visit:
In-Network:20%
Out-of-Network:30%
Skilled Nursing FacilityIn-Network:In 2019 the amounts for each benefit period are:
$0 copay for days 1 through 20
$170.50 copay per day for days 21 through 100
Out-of-Network:30% per stay
Rehabilitation servicesOccupational therapy visit:
In-Network:20%
Out-of-Network:30%
Physical therapy and speech and language therapy visit:
In-Network:20%
Out-of-Network:30%
Ground ambulanceIn-Network:20%
Out-of-Network:20%
TransportationIn-Network:$0 copay
Out-of-Network:75%There may be limits on how much the plan will provide.
Foot care (podiatry services)Foot exams and treatment:
In-Network:20%
Out-of-Network:30%
Routine foot care:
In-Network:$0
Out-of-Network:30%There may be limits on how much the plan will provide.
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
In-Network:20% per item
Out-of-Network:30% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:20% per item
Out-of-Network:30% per item
Diabetes supplies:
In-Network:$0 per item
Out-of-Network:30% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
In-Network:20%
Out-of-Network:20%
Other Part B drugs:
In-Network:20%
Out-of-Network:20%

Benefits Services

Hearing
Hearing examIn-Network: $0 copay
Out-of-Network: 30%
Fitting/evaluationNot covered
Hearing aids - inner earIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Hearing aids - outer earNot covered
Hearing aids - over the earIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Preventive Dental
Oral examIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
CleaningIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Fluoride treatmentIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Dental x-ray(s)In-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Comprehensive Dental
Non-routine servicesNot covered
Diagnostic servicesIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Restorative servicesIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
EndodonticsIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
PeriodonticsIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
ExtractionsIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Prosthodontics, other oral/maxillofacial surgery, other servicesIn-Network: $0
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Vision
Routine eye examIn-Network: $0
Out-of-Network: 30%
There may be limits on how much the plan will provide.
OtherNot covered
Contact lensesIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Eyeglasses (frames and lenses)Not covered
Eyeglass framesIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
Eyeglass lensesIn-Network: $0 copay
Out-of-Network: $0 copay
There may be limits on how much the plan will provide.
UpgradesNot covered

Coverage Area for UnitedHealthcare MedicareComplete Assure (PPO)

StateArizona
CountyYuma

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds25% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered25% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 5: Specialty TierNot offered25% coinsuranceNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered25% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered25% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 5: Specialty TierNot offered25% coinsuranceNot offered

Physicians that accept UnitedHealthcare MedicareComplete Assure (PPO) for Arizona

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Rajesh, Khona
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Hazem, Shehata
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Sathya, Vemuri
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Ruth, Waldrop
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Kwasi, Wilson
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Ahmad, Ashfaq
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Keerti, Khandelwal
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Shivang, Shah
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Yuma Gastroenterology Pc
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Leona, Martin
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Renee, Monteiro
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Natalia, Galarza Carrazco
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Simi, Dhillon
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Nina, Greene
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George, Darwin
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Stephen, Njoroge
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Sunil, Deokule
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Kristine, Bernardo
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Darrell, Scheetz
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Nader, Haddad
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Dania, Sweidan
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Jemylene, Evangelista
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Henri, Carter
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Rajesh Khona, M.D.
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  • Phone Number
    (602) 273-6770
  • Office Locations
    2400 S Avenue A
    Yuma, AZ 85364
2400 S Avenue A Yuma AZ, 85364
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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)

Medicare Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)