UnitedHealthcare Dual Complete (HMO SNP)

Medicare Advantage Plan for Iowa

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH0169-1-0
CMS RatingNot Rated1
Plan TypeHMO 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
  • has no additional premium costs outside of your Medicare Part B premium

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)
$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

Service
Cost
Inpatient hospital coverage
$0 copay
Outpatient hospital coverage
$0 copay
Doctor visits
Primary:$0 copay
Specialist:$0 copay
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:$0 copay
Urgent care:$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:$0 copay
Lab services:$0 copay
Diagnostic radiology services (e.g., MRI):$0 copay
Outpatient x-rays:$0 copay
Mental health services
$0 copay
Outpatient group therapy visit with a psychiatrist:$0 copay
Outpatient individual therapy visit with a psychiatrist:$0 copay
Outpatient group therapy visit:$0 copay
Outpatient individual therapy visit:$0 copay
Skilled Nursing Facility
$0 copay
Rehabilitation services
Occupational therapy visit:$0 copay
Physical therapy and speech and language therapy visit:$0 copay
Ambulance
$0 copay
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:$0 copay
Routine foot care:$0
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):$0 copay
Prosthetics (e.g., braces, artificial limbs):$0 copay
Diabetes supplies:$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:$0 copay
Other Part B drugs:$0 copay

Coverage Area for UnitedHealthcare Dual Complete (HMO SNP)

StateIowa
CountyPolk

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 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

Physician Finder

Physicians that accept UnitedHealthcare Dual Complete (HMO SNP) for Iowa

/
MULHAUSEN, PAUL
3509 E 29TH ST
DES MOINES, IA 50317
MOHR, BRITON
2918 E UNIVERSITY AVE
DES MOINES, IA 50317
MITRA, CHANDAN
3509 E 29TH ST
DES MOINES, IA 50317
NANSON, JOHN
1607 E 33RD ST
DES MOINES, IA 50317
IBRAHIM, TOMMY
3509 E 29TH ST
DES MOINES, IA 50317
HOCK, AMY
2918 E UNIVERSITY AVE
DES MOINES, IA 50317
CONVERY, LOUISE
3509 E 29TH ST
DES MOINES, IA 50317
YOUNT, DAVID
2459 E EUCLID AVE
DES MOINES, IA 50317
OLSON, LEATRICE
3509 E 29TH ST
DES MOINES, IA 50317
HAWKINS, RONNIE
3509 E 29TH ST
DES MOINES, IA 50317
BALDI, DANIEL
1301 PENNSYLVANIA AVE
DES MOINES, IA 50316
MAYFIELD, TIMOTHY
1301 PENN AVE
DES MOINES, IA 50316
MITCHELL, MARIA
2301 E 14TH ST
DES MOINES, IA 50316
GANSKE, CORRINE
840 E UNIVERSITY AVE
DES MOINES, IA 50316
BERRY, GREGORY
1201 PENNSYLVANIA AVE
DES MOINES, IA 50316
MOON JR, KENNETH
2301 EAST 14TH STREET
DES MOINES, IA 50316
LIN, IAN
1301 PENN AVE
DES MOINES, IA 50316
RICHARDS, L
1301 PENN AVE
DES MOINES, IA 50316
SIDNEY, REBECCA
1201 PENNSYLVANIA AVE
DES MOINES, IA 50316
NEU, STACEY
840 E UNIVERSITY AVE
DES MOINES, IA 50316
CAHALAN, STEVEN
1301 PENN AVE
DES MOINES, IA 50316
LUEPKE, MICHAEL
1201 PENN AVE
DES MOINES, IA 50316
PALAKURTHY, PRASAD
1301 PENN AVE
DES MOINES, IA 50316
STEVENS, CRAIG
1301 PENN AVENUE
DES MOINES, IA 50316
Details
PAUL MULHAUSEN, MD
Phone Number
(515) 248-1600
Office Locations
3509 E 29TH ST
DES MOINES, IA 50317
3509 E 29TH ST DES MOINES IA, 50317

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