UnitedHealthcare Nursing Home (PPO SNP)

Medicare Advantage Plan for Arizona

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH0710-5-0
CMS Rating1
Plan TypePPO SNP
Annual Deductible$405.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$10,000 In and Out-of-network $6,700 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$32.90
Monthly Health Plan Premium
$0.00

Benefits

Service
Cost
Inpatient hospital coverage
In-Network:
$1,300 per stay. Out-of-Network:
$1,300 per stay
Outpatient hospital coverage
In-Network:
20% per visit. Out-of-Network:
30% per visit
Doctor visits
Primary:In-Network:
$0 copay. Out-of-Network:
30% per visit
Specialist:In-Network:
0-20% per visit. Out-of-Network:
30% per visit
Preventive care
In-Network:
$0 copay. Out-of-Network:
0-30%
Emergency care/Urgent care
Emergency:$0 copay
Urgent care:$65 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:In-Network:
0-20%Out-of-Network:
30%
Lab services:In-Network:
$0Out-of-Network:
$0 copay
Diagnostic radiology services (e.g., MRI):In-Network:
0-20%Out-of-Network:
30%
Outpatient x-rays:In-Network:
$0Out-of-Network:
30%
Mental health services
In-Network:
$1,300 per stay. Out-of-Network:
$1,300 per stay
Outpatient group therapy visit with a psychiatrist:In-Network:
0-20%Out-of-Network:
30%
Outpatient individual therapy visit with a psychiatrist:In-Network:
0-20%Out-of-Network:
30%
Outpatient group therapy visit:In-Network:
0-20%Out-of-Network:
30%
Outpatient individual therapy visit:In-Network:
0-20%Out-of-Network:
30%
Skilled Nursing Facility
In-Network:
$0 for days 1 through 100Out-of-Network:
30% per stay
Rehabilitation services
Occupational therapy visit:In-Network:
$0 copay. Out-of-Network:
30%
Physical therapy and speech and language therapy visit:In-Network:
$0 copay. Out-of-Network:
30%
Ambulance
In-Network:
20%Out-of-Network:
20%
Transportation
In-Network:
$0 copay. Out-of-Network:
75%
Foot care (podiatry services)
Foot exams and treatment:In-Network:
0-20%Out-of-Network:
30%
Routine foot care:In-Network:
$0Out-of-Network:
30%
Medical equipment/supplies
Durable 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:
0-20% per item. Out-of-Network:
30% per item
Diabetes supplies:In-Network:
20% per item. Out-of-Network:
30% per item
Wellness programs (e.g., fitness, nursing hotline)
Not covered
Medicare Part B drugs
Chemotherapy:In-Network:
20%Out-of-Network:
30%
Other Part B drugs:In-Network:
20%Out-of-Network:
30%

Coverage Area for UnitedHealthcare Nursing Home (PPO SNP)

StateArizona
CountyYuma

Cost Sharing Information

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

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Not Rated
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
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
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Not Rated
Overall rating of health care quality
Not Rated
Overall rating of plan
Not Rated
Care Coordination
Not Rated

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Not Rated
Members choosing to leave the health plan
Not Rated
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
Not Rated
High risk medication
Not Rated
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept UnitedHealthcare Nursing Home (PPO SNP) for Arizona

/
KAYE, ROBERT
1501 W 24TH ST
YUMA, AZ 85364
KHONA, RAJESH
2400 S AVENUE A
YUMA, AZ 85364
SANGHVI, ASHESH
1030 W 24TH ST
YUMA, AZ 85364
EVANGELISTA, JEMYLENE
2435 S AVENUE A STE A
YUMA, AZ 85364
LWIN, TIN
2400 S AVE A
YUMA, AZ 85364
ALROMAIHI, DALAL
2270 S RIDGEVIEW DR
YUMA, AZ 85364
THANT, DIANA
1030 W 24TH ST
YUMA, AZ 85364
SMYTHE, ROBERT
2775 S 8TH AVE
YUMA, AZ 85364
LEIFERMAN, JAMES
2400 S AVENUE A
YUMA, AZ 85364
LAU, AUGUSTINE
2375 S. RIDGEVIEW DRIVE
YUMA, AZ 85364
BELLOT, ISABEL
2851 S AVE B
YUMA, AZ 85364
COHEN, STANTON
1743 W 24TH ST
YUMA, AZ 85364
SUBBU, SONAL
2150 W 24TH ST
YUMA, AZ 85364
CLARK, RICK
1394 W 16TH ST
YUMA, AZ 85364
GALANG, TIMOTHY
1320 W 24TH ST
YUMA, AZ 85364
GROGAN, BRIAN
2911 S 8TH AVE
YUMA, AZ 85364
GASCA-HOLTZ, MARIA
2911 S 8TH AVE
YUMA, AZ 85364
MARTINEZ, ERICK
2911 S 8TH AVE
YUMA, AZ 85364
SUCIU, THOMAS
2911 S 8TH AVE
YUMA, AZ 85364
WARDA, GREGORY
2400 S AVENUE A
YUMA, AZ 85364
NGUYEN, LOC
1001 W 16TH ST
YUMA, AZ 85364
MATOS, EMILIA
1073 W 23RD ST
YUMA, AZ 85364
HOURANI, ABDULKADIR
2051 W 25TH ST
YUMA, AZ 85364
WONG, DOROTHY
1025 W 24TH ST
YUMA, AZ 85364
Details
ROBERT KAYE, M.D.
Phone Number
(928) 336-7846
Office Locations
1501 W 24TH ST
YUMA, AZ 85364
1501 W 24TH ST YUMA AZ, 85364

Similar Plans

PremiumPlan NameCMS Rating
from $0
AARP MedicareComplete (HMO)
Details
from $0
CareMore Smart Value (HMO)
Details
from $0
Cigna-HealthSpring Preferred (HMO)
Details
from $12
Aetna Medicare Rx Select (PDP)
Details
from $0
Humana Gold Plus H2649-031 (HMO)
Details

Related Articles

Related Searches

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.

{}