2018 UnitedHealthcare Nursing Home Plan (PPO SNP) H0710-15-0 in ME from UnitedHealthcare | HealthPocket

UnitedHealthcare Nursing Home Plan (PPO SNP)

$411/mo

Apply For This Plan

Zip Code04401
Applicant10/23/1983 Male
Coverage Start10/24/2018
Apply Now

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH0710-15-0
Plan Year2018
CMS Rating
Plan TypePPO 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$34.30
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverageIn-Network:
$1,300 per stay
Out-of-Network:
$1,300 per stay
Outpatient hospital coverageIn-Network:
20% per visit
Out-of-Network:
30% per visit
Doctor visitsPrimary:
In-Network:
$0 copay
Out-of-Network:
30% per visit
Specialist:
In-Network:
0-20% per visit
Out-of-Network:
30% per visit
Preventive careIn-Network:
$0 copay
Out-of-Network:
0-30%
Emergency care/Urgent careEmergency:
$80 per visit (always covered)
Urgent care:
$65 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
In-Network:
0-20%
Out-of-Network:
30%
Lab services:
In-Network:
$0
Out-of-Network:
$0 copay
Diagnostic radiology services (e.g., MRI):
In-Network:
0-20%
Out-of-Network:
30%
Outpatient x-rays:
In-Network:
$0
Out-of-Network:
30%
Mental health servicesIn-Network:
$1,300 per stay
Out-of-Network:
$1,300 per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:
0-20%
Out-of-Network:
30%
Outpatient individual therapy visit with a psychiatrist:
In-Network:
0-20%
Out-of-Network:
30%
Outpatient group therapy visit:
In-Network:
0-20%
Out-of-Network:
30%
Outpatient individual therapy visit:
In-Network:
0-20%
Out-of-Network:
30%
Skilled Nursing FacilityIn-Network:
$0 for days 1 through 100
Out-of-Network:
30% per stay
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:
20%
Out-of-Network:
20%
TransportationIn-Network:
$0 copay
Out-of-Network:
75%
Foot care (podiatry services)Foot exams and treatment:
In-Network:
0-20%
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:
20% per item
Out-of-Network:
30% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:
0-20% per item
Out-of-Network:
30% per item
Diabetes supplies:
In-Network:
20% per item
Out-of-Network:
30% per item
Wellness programs (e.g., fitness, nursing hotline)Not covered
Medicare Part B drugsChemotherapy:
In-Network:
20%
Out-of-Network:
30%
Other Part B drugs:
In-Network:
20%
Out-of-Network:
30%

Coverage Area for UnitedHealthcare Nursing Home (PPO SNP)

StateMaine
CountyPenobscot

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 offereds25% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered25% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 5: Specialty TierNot offered25% coinsuranceNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered25% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered25% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered25% coinsuranceNot offered
Tier 5: Specialty TierNot offered25% coinsuranceNot offered

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccineNot Rated
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 serviceNot Rated
Overall rating of health care qualityNot Rated
Overall rating of planNot Rated
Care CoordinationNot Rated

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health planNot Rated
Members choosing to leave the health planNot Rated
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 - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
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 AccuracyNot Rated
High risk medicationNot Rated
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 Nursing Home (PPO SNP) for Maine

/
Please select the correct zip
Bruno, Edwin
View All Details
Mcguire, D
View All Details
Comeau, Stephen
View All Details
Phillips, Lewis
View All Details
Hooge, John
View All Details
Graustein, Bradley
View All Details
Nawaz, Haq
View All Details
Surran, Brooke
View All Details
Pouzol, Philip
View All Details
Mitchell, Samantha
View All Details
Lommler, Elmer
View All Details
Khadka, Poonam
View All Details
Bourque, Suzanne
View All Details
Mukhtar, Jalal
View All Details
White, Barbara
View All Details
Mohan, Vinod
View All Details
Edwin Bruno, D.P.M.
View All Details
  • Phone Number
    (207) 942-3988
  • Office Locations
    277 State St
    Bangor, ME 04401
277 State St Bangor ME, 04401

get free advice

Speak With A Licensed Agent

Call (800) 931-6467

Learn More

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