2019 AARP MedicareComplete Choice (PPO) H1278-2-0 in IA from UnitedHealthcare | HealthPocket

AARP MedicareComplete Choice (PPO)

$28/mo

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Zip Code50317
Applicant8/20/1984 Male
Coverage Start8/21/2019
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH1278-2-0
Plan Year2019
CMS RatingNot Rated
Plan TypePPO
Annual Deductible$250.00

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

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

Costs and Other Important Information

Plan Year2019
Monthly Health Plan Premium$0.00
Monthly Drug Plan Premium$28.00
Health Plan Deductible$0
Other health plan deductibles?No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$10,000 In and Out-of-network
$5,500 In-network
Optional Supplemental BenefitsYes

Benefits

SERVICECOST
Inpatient hospital coverageIn-Network:$395 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 91 and beyond
Out-of-Network:40% per stay
Outpatient hospital coverageIn-Network:$395 per visit
Out-of-Network:40% per visit
Doctor visitsPrimary:
In-Network:$10 per visit
Out-of-Network:$30 per visit
Specialist:
In-Network:$50 per visit
Out-of-Network:$70 per visit
Preventive careIn-Network:$0 copay
Out-of-Network:0-40%
Emergency care/Urgent careEmergency:$90 per visit (always covered)
Urgent care:$30-40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
In-Network:$20
Out-of-Network:40%
Lab services:
In-Network:$10
Out-of-Network:$10
Diagnostic radiology services (e.g., MRI):
In-Network:$100
Out-of-Network:40%
Outpatient x-rays:
In-Network:$14
Out-of-Network:$21
Mental health servicesInpatient hospital - psychiatric:
In-Network:$395 per day for days 1 through 4
$0 per day for days 5 through 90
Out-of-Network:40% per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:$30
Out-of-Network:$50-60
Outpatient individual therapy visit with a psychiatrist:
In-Network:$40
Out-of-Network:$50-60
Outpatient group therapy visit:
In-Network:$30
Out-of-Network:$50-60
Outpatient individual therapy visit:
In-Network:$40
Out-of-Network:$50-60
Skilled Nursing FacilityIn-Network:$0 per day for days 1 through 20
$160 per day for days 21 through 55
$0 per day for days 56 through 100
Out-of-Network:40% per stay
Rehabilitation servicesOccupational therapy visit:
In-Network:$40
Out-of-Network:$70
Physical therapy and speech and language therapy visit:
In-Network:$40
Out-of-Network:$70
Ground ambulanceIn-Network:$225
Out-of-Network:$225
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
In-Network:$50
Out-of-Network:$70
Routine foot care:
In-Network:$50
Out-of-Network:$70There 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:50% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:20% per item
Out-of-Network:40% per item
Diabetes supplies:
In-Network:$0 per item
Out-of-Network:40% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
In-Network:20%
Out-of-Network:40%
Other Part B drugs:
In-Network:20%
Out-of-Network:40%

Benefits Services

Hearing
Hearing examIn-Network: $10
Out-of-Network: $70
Fitting/evaluationNot covered
Hearing aidsIn-Network: $100-1,825
Out-of-Network: $100-170
There may be limits on how much the plan will provide.
Preventive Dental
Oral examIn-Network: $0 copay
Out-of-Network: 50%
There may be limits on how much the plan will provide.
CleaningIn-Network: $0 copay
Out-of-Network: 50%
There may be limits on how much the plan will provide.
Fluoride treatmentNot covered
Dental x-ray(s)In-Network: $0 copay
Out-of-Network: 50%
There may be limits on how much the plan will provide.
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: $70
There may be limits on how much the plan will provide.
OtherNot covered
Contact lensesIn-Network: $0 copay
Out-of-Network: 40%
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: 40%
There may be limits on how much the plan will provide.
Eyeglass lensesIn-Network: $0 copay
Out-of-Network: 40%
There may be limits on how much the plan will provide.
UpgradesNot covered

Coverage Area for AARP MedicareComplete Choice (PPO)

StateIowa
CountyPolk

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$3 copayNot offered
Tier 2: Non-Preferred GenericNot offered$10 copayNot offered
Tier 3: Preferred Brand NameNot offered$47 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$100 copayNot offered
Tier 5: Specialty TierNot offered28% coinsuranceNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$9 copay$0 copay
Tier 2: Non-Preferred GenericNot offered$30 copay$0 copay
Tier 3: Preferred Brand NameNot offered$141 copay$131 copay
Tier 4: Non-Preferred Brand NameNot offered$300 copay$290 copay
Tier 5: Specialty TierNot offered28% coinsurance28% coinsurance

Physicians that accept AARP MedicareComplete Choice (PPO) for Iowa

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David, Yount
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Louise, Convery
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Briton, Mohr
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Chandan, Mitra
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John, Nanson
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Jose, Angel
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Lisa, Klock
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Leatrice, Olson
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Ronnie, Hawkins
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Paul, Mulhausen
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Lynn, Rankin
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Michael, Quinn
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John, Pargulski
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John, Stern
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Leonard, Richards
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Jennifer, Pate
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John, Gaffey
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Timothy, Hart
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Craig, Clark
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Barron, Bremner
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Mukti, Aich
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Devi, Mikkilineni
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David Yount, D.P.M.
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  • Phone Number
    (515) 262-5856
  • Office Locations
    2459 E Euclid Ave
    Des Moines, IA 50317
2459 E Euclid Ave Des Moines IA, 50317

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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)