2020 Erickson Advantage Signature with Drugs (HMO-POS) H5652-1-0 in CO from UnitedHealthcare | HealthPocket

Erickson Advantage Signature with Drugs (HMO-POS)

$195/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH5652-1-0
Plan Year2020
CMS Rating
Plan TypeHMO-POS
Annual Deductible$0.00
Out-of-Pocket Maximum2900

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

Why We Like This Plan
  • has both Health and Drug Coverage

Overview

Premium
Total monthly premium$195.00
Health plan premium$148.00
Drug plan premium$47.00
Standard Part B premium$135.50
Part B premium reductionNo
Deductible
Health plan deductible$0
Drug plan deductible$0.00
Estimated yearly costs
Estimated total yearly costs for care$5,838.00
Out-of-pocket max
Out-of-pocket max$2,900 In-network

Benefits & costs

Doctor services
Primary doctor visitIn-network: $0 copay
Out-of-network: 30% per visit
Specialist visitIn-network: $20 per visit
Out-of-network: 30% per visit
Tests, labs, & imaging
Diagnostic tests & proceduresIn-network: $0 copay
Out-of-network: 30%
Lab servicesIn-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)In-network: $0-50
Out-of-network: 30%
Outpatient x-raysIn-network: $20
Out-of-network: 30%
Emergency care$75 per visit (always covered)
Urgent care$30 per visit (always covered)
Hospital services
Inpatient hospital coverageIn-network: $0 copay per stay
$0 per day for days 91 and beyond
Out-of-network: 30% per stay
Outpatient hospital coverageIn-network: $0-50 per visit
Out-of-network: 30% per visit
Skilled nursing facility
Skilled nursing facilityIn-network: $0 per day for days 1 through 100
Out-of-network: 30% per stay
Preventive services
Preventive servicesIn-network: $0 copay
Out-of-network: 0-30%
Ambulance
Ground ambulanceIn-network: $155
Out-of-network: $155
Therapy services
Occupational therapy visitIn-network: $0 copay
Out-of-network: 30%
Physical therapy & speech & language therapy visitIn-network: $0 copay
Out-of-network: 30%
Mental health services
Outpatient group therapy with a psychiatristIn-network: $30
Out-of-network: 30%
Outpatient individual therapy with a psychiatristIn-network: $30
Out-of-network: 30%
Outpatient group therapy visitIn-network: $0 copay
Out-of-network: 30%
Outpatient individual therapy visitIn-network: $0-30
Out-of-network: 30%
Opioid treatment services
Opioid treatment servicesCovered
Other services
Durable medical equipment (like wheelchairs & oxygen)In-network: 20% per item
Out-of-network: 30% per item
Prosthetics (like braces, artificial limbs)In-network: 20% per item
Out-of-network: 30% per item
Diabetes suppliesIn-network: 20% per item
Out-of-network: 30% per item

Extra benefits & costs

Hearing
Hearing examIn-network: $0 copay
Out-of-network: 30%
Fitting/evaluationNot covered
Hearing aids - All typesIn-network: $375-2,075
Out-of-network: $375
Preventive dental
Oral examIn-network: $0 copay
Out-of-network: $0 copay
CleaningIn-network: $0 copay
Out-of-network: $0 copay
Fluoride treatmentIn-network: $0 copay
Out-of-network: $0 copay
Dental x-raysIn-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Non-routine servicesNot covered
Diagnostic servicesNot covered
Restorative servicesNot covered
EndodonticsNot covered
PeriodonticsNot covered
ExtractionsNot covered
Prosthodontics, other oral/maxillofacial surgery, other servicesNot covered
Vision
Routine eye examIn-network: $0 copay
Out-of-network: 30%
Contact lensesIn-network: $0 copay
Out-of-network: 50%
Eyeglasses (frames & lenses)In-network: $0 copay
Out-of-network: 50%
Eyeglass frames (only)Not covered
Eyeglass lenses (only)Not covered
UpgradesNot covered
More benefits
Fitness benefitNot covered
Transportation services for non-emergency care: Any health-related locationsNot covered
Transportation services for non-emergency care: Plan-approved locationsLimited coverage
Over the counter drug benefitsNot covered
In-home support servicesLimited coverage
Home and bathroom safety devicesNot covered
Meals for short durationNot covered
Annual physical examsLimited coverage
TelehealthNot covered

Drug coverage & costs

Part B drugs
Chemotherapy drugsIn-network: 10%
Out-of-network: 30%
Other Part B drugsIn-network: 10%
Out-of-network: 30%

Coverage Area for Erickson Advantage Signature with Drugs (HMO-POS)

StateColorado
CountyDenver

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


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$5 copayNot offeredNot offered
Tier 2: Non-Preferred GenericNot offereds$15 copayNot offeredNot offered
Tier 3: Preferred Brand NameNot offereds$45 copayNot offeredNot offered
Tier 4: Non-Preferred Brand NameNot offereds$85 copayNot offeredNot offered
Tier 5: Specialty TierNot offereds33% coinsuranceNot offeredNot offered
Tier 6: Select Care Drugs

90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$15 copay$0 copay$15 copay
Tier 2: Non-Preferred GenericNot offereds$45 copay$0 copay$45 copay
Tier 3: Preferred Brand NameNot offereds$135 copay$125 copay$135 copay
Tier 4: Non-Preferred Brand NameNot offereds$255 copay$245 copay$255 copay
Tier 5: Specialty TierNot offereds33% coinsurance33% coinsurance33% coinsurance
Tier 6: Select Care Drugs

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
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 assessment
Osteoporosis management in women who had a fractureNot Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Rheumatoid arthritis managementNot Rated
Reducing the risk of falling
Improving bladder control
Medication reconciliation post-discharge
Plan all-cause readmissions
Statin Therapy for Patients with Cardiovascular DiseaseNot Rated

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Rating of health care quality
Rating of health plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Health plan quality improvement

Health Plan Customer Service

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

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forward
Appeals upheldNot Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
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
Medication adherence for diabetes medications
Medication adherence for hypertension - RAS antagonists
Medication adherence for cholesterol - Statins
MTM program completion rate for CMR
Statin use in persons with diabetes - SUPD

Physicians that accept Erickson Advantage Signature with Drugs (HMO-POS) for Colorado

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Larry, Fisher
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Antony Nguyen, Vanbang
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Cuong, Ngo
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Mark, Elles
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Raymond, Garrett
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Dinh, Nguyen
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Jesse, Sutherland
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Khoi, Nguyen
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Roy, Durbin
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Kathy, Mccranie
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Brian, Lambden
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Rachel, Basse
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Tracy, Hofeditz
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Martin, Thumim
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Loan, Pham
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Darla, Draper
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Larry Fisher, MD
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  • Phone Number
    (303) 935-9142
  • Office Locations
    1930 S Federal Blvd
    Denver, CO 80219
1930 S Federal Blvd Denver CO, 80219
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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family 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 part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

Medicare Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family 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 part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).