2020 AARP Medicare Advantage Walgreens (PPO) H3442-3-0 in MA from UnitedHealthcare | HealthPocket

AARP Medicare Advantage Walgreens (PPO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH3442-3-0
Plan Year2020
CMS RatingNot Rated
Plan TypePPO
Annual Deductible$195.00
Out-of-Pocket Maximum6700

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
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Overview

Premium
Total monthly premium$0.00
Health plan premium$0.00
Drug plan premium$0.00
Standard Part B premium$135.50
Part B premium reductionNo
Deductible
Health plan deductible$0
Drug plan deductible$195.00
Estimated yearly costs
Estimated total yearly costs for care$3,990.00
Out-of-pocket max
Out-of-pocket max$6,700 In and Out-of-network
$6,700 In-network

Benefits & costs

Doctor services
Primary doctor visitIn-network: $0 copay
Out-of-network: $25 per visit
Specialist visitIn-network: $45 per visit
Out-of-network: $50 per visit
Tests, labs, & imaging
Diagnostic tests & proceduresIn-network: $30
Out-of-network: 40%
Lab servicesIn-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)In-network: $0-130
Out-of-network: 40%
Outpatient x-raysIn-network: $14
Out-of-network: $21
Emergency care$90 per visit (always covered)
Urgent care$30-40 per visit (always covered)
Hospital services
Inpatient hospital coverageIn-network: $370 per day for days 1 through 5
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
Out-of-network: 40% per stay
Outpatient hospital coverageIn-network: $0-295 per visit
Out-of-network: 40% per visit
Skilled nursing facility
Skilled nursing facilityIn-network: $0 per day for days 1 through 20
$160 per day for days 21 through 62
$0 per day for days 63 through 100
Out-of-network: 40% per stay
Preventive services
Preventive servicesIn-network: $0 copay
Out-of-network: 0-40%
Ambulance
Ground ambulanceIn-network: $250
Out-of-network: $250
Therapy services
Occupational therapy visitIn-network: $40
Out-of-network: $50
Physical therapy & speech & language therapy visitIn-network: $40
Out-of-network: $50
Mental health services
Outpatient group therapy with a psychiatristIn-network: $30
Out-of-network: $35-45
Outpatient individual therapy with a psychiatristIn-network: $40
Out-of-network: $35-45
Outpatient group therapy visitIn-network: $30
Out-of-network: $35-45
Outpatient individual therapy visitIn-network: $40
Out-of-network: $35-45
Opioid treatment services
Opioid treatment servicesCovered
Other services
Durable medical equipment (like wheelchairs & oxygen)In-network: 20% per item
Out-of-network: 50% per item
Prosthetics (like braces, artificial limbs)In-network: 20% per item
Out-of-network: 40% per item
Diabetes suppliesIn-network: $0 per item
Out-of-network: 40% per item

Extra benefits & costs

Hearing
Hearing examIn-network: $0 copay
Out-of-network: $50
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 servicesIn-network: 50%
Out-of-network: 0-50%
Diagnostic servicesNot covered
Restorative servicesIn-network: 0-50%
Out-of-network: 0-50%
EndodonticsNot covered
PeriodonticsIn-network: 50%
Out-of-network: 0-50%
ExtractionsIn-network: 50%
Out-of-network: 0-50%
Prosthodontics, other oral/maxillofacial surgery, other servicesIn-network: 0-50%
Out-of-network: 0-50%
Vision
Routine eye examIn-network: $0 copay
Out-of-network: $50
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 benefitLimited coverage
Over the counter drug benefitsLimited coverage
In-home support servicesNot covered
Home and bathroom safety devicesNot covered
Meals for short durationNot covered
Annual physical examsLimited coverage
TelehealthLimited coverage

Drug coverage & costs

Part B drugs
Chemotherapy drugsIn-network: 20%
Out-of-network: 40%
Other Part B drugsIn-network: 20%
Out-of-network: 40%

Coverage Area for AARP Medicare Advantage Walgreens (PPO)

StateMassachusetts
CountySuffolk

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 Generic$0 copay$10 copayNot offeredNot offered
Tier 2: Non-Preferred Generic$5 copay$20 copayNot offeredNot offered
Tier 3: Preferred Brand Name$47 copay$47 copayNot offeredNot offered
Tier 4: Non-Preferred Brand Name$100 copay$100 copayNot offeredNot offered
Tier 5: Specialty Tier29% coinsurance29% 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 Generic$0 copay$30 copay$0 copay$30 copay
Tier 2: Non-Preferred Generic$10 copay$60 copay$10 copay$60 copay
Tier 3: Preferred Brand Name$131 copay$141 copay$131 copay$141 copay
Tier 4: Non-Preferred Brand Name$290 copay$300 copay$290 copay$300 copay
Tier 5: Specialty Tier29% coinsurance29% coinsurance29% coinsurance29% coinsurance
Tier 6: Select Care Drugs

Physicians that accept AARP Medicare Advantage Walgreens (PPO) for Massachusetts

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Jackie, Fantes
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Loretta, Chou
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Barbara, Lambl
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Stephanie, Quamo
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Margareth, Chua
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Michelle, Master
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Mothusi, Chilume
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Ricardo, Ribeiro
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Panagiotis, Trilianos
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Leah, Braun
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Nikolai, Velev
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Laura, Chamberlain
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Anu, Mehra
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Juan, Huanuco Perez
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Tanya, Geha
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Daniel, Shen
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Elizabeth, Gaskins
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Hernan, Lopez Morra
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Lilia, Cardenas
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Jackie Fantes, MD
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  • Phone Number
    (617) 569-5800
  • Office Locations
    10 Gove St
    East Boston, MA 02128
10 Gove St East Boston MA, 02128

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).