2018 UnitedHealthcare Dual Complete RP (Regional PPO SNP) R3175-3-0 in HI from UnitedHealthcare | HealthPocket

UnitedHealthcare Dual Complete RP (Regional PPO SNP)

$22/mo

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Zip Code96818
Applicant12/13/1983 Male
Coverage Start12/14/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDR3175-3-0
Plan Year2018
CMS Rating
Plan TypeRegional PPO SNP
Annual Deductible$405.00

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2019. see plan

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

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsNo
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$0.00
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverageIn-Network:
$0 copay
Out-of-Network:
30% per stay
Outpatient hospital coverageIn-Network:
$0 copay
Out-of-Network:
30% per visit
Doctor visitsPrimary:
In-Network:
$0 copay
Out-of-Network:
30% per visit
Specialist:
In-Network:
$0 copay
Out-of-Network:
30% per visit
Preventive careIn-Network:
$0 copay
Out-of-Network:
0-30%
Emergency care/Urgent careEmergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
In-Network:
$0 copay
Out-of-Network:
30%
Lab services:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Diagnostic radiology services (e.g., MRI):
In-Network:
$0 copay
Out-of-Network:
30%
Outpatient x-rays:
In-Network:
$0 copay
Out-of-Network:
30%
Mental health servicesIn-Network:
$0 copay
Out-of-Network:
30% per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
30%
Outpatient individual therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
30%
Outpatient group therapy visit:
In-Network:
$0 copay
Out-of-Network:
30%
Outpatient individual therapy visit:
In-Network:
$0 copay
Out-of-Network:
30%
Skilled Nursing FacilityIn-Network:
$0 copay
Out-of-Network:
Coming soon
Rehabilitation servicesOccupational 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%
AmbulanceIn-Network:
$0 copay
Out-of-Network:
20%
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
In-Network:
$0 copay
Out-of-Network:
30%
Routine foot care:
In-Network:
$0
Out-of-Network:
30%
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
In-Network:
$0 copay
Out-of-Network:
30% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:
$0 copay
Out-of-Network:
30% per item
Diabetes supplies:
In-Network:
$0 copay
Out-of-Network:
30% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
In-Network:
$0 copay
Out-of-Network:
20%
Other Part B drugs:
In-Network:
$0 copay
Out-of-Network:
20%

Coverage Area for UnitedHealthcare Dual Complete RP (Regional PPO SNP)

StateHawaii
CountyHonolulu

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 offereds$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$0 copayNot offered
Tier 3: Preferred Brand NameNot offered$0 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$0 copayNot offered
Tier 5: Specialty TierNot offered$0 copayNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$0 copayNot offered
Tier 3: Preferred Brand NameNot offered$0 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$0 copayNot offered
Tier 5: Specialty TierNot offered$0 copayNot offered

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 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
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
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 - MedicalNot Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - DrugsNot Rated
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 planNot 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
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physicians that accept UnitedHealthcare Dual Complete RP (Regional PPO SNP) for Hawaii

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Ayon, Dennis
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Cole, Jasmin
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Teramoto, Ron
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Marumoto, Marsha
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Kobayashi, Joel
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Smedegaard, Eric
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Ragunton, Luis
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Schiff, Robert
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Shu, Huidy
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Grebe, Werner
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Suzuki, Mona
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Davis, Geoffrey
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Fujita, Jan
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Kokame, Gregg
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Sung, Stanley
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Martyak, Anthony
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Pitts, Charles
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Lee-horita, Julie-ann
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Sharipova, Elena
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Harada, Daniel
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Mai, David
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Mai, Christopher
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Yamazaki, Mika
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Suga, Wayne
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Lai, James
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Dennis Ayon, M.D.
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  • Phone Number
    (808) 594-7845
  • Office Locations
    5333 Likini St
    Honolulu, HI 96818
5333 Likini St Honolulu HI, 96818

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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.

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.