UnitedHealthcare Dual Complete (HMO SNP)

Medicare Advantage Plan for Missouri

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH0169-2-0
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
$0 copay
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)

StateMissouri
CountySt. Louis

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 Missouri

/
FIGURA, MICHAEL
4105 UNION RD
SAINT LOUIS, MO 63129
OJASCASTRO-SALARANO, CHRISTINA
5715 TELEGRAPH RD
SAINT LOUIS, MO 63129
MAMMEN, ALEXANDER
4530 LEMAY FERRY RD
SAINT LOUIS, MO 63129
LAUTER, STEVEN
5201 MID AMERICA PLZ
SAINT LOUIS, MO 63129
OJASCASTRO, ALEJANDRO
5715 TELEGRAPH RD
SAINT LOUIS, MO 63129
SANDHU, HARPARTAP
939 SAJAKEED DR
SAINT LOUIS, MO 63129
OJASCASTRO, VICTORIA
5715 TELEGRAPH RD
SAINT LOUIS, MO 63129
DATTA, SUDIP
639 TANYA COURT DR
SAINT LOUIS, MO 63129
STATEN, STEPHEN
4438 TELEGRAPH RD
SAINT LOUIS, MO 63129
RAJA, FARHEEN
6324 TELEGRAPH RD
SAINT LOUIS, MO 63129
WAGSTAFF, DONNA
4438 TELEGRAPH RD
SAINT LOUIS, MO 63129
GRABOWSKI, ANDREW
4438 TELEGRAPH RD
SAINT LOUIS, MO 63129
BERKIN, SHAWN
5524 TELEGRAPH ROAD
ST LOUIS, MO 63129
SHAH, JAY
5541 TELEGRAPH ROAD
SAINT LOUIS, MO 63129
DANG, QUOC
10010 KENNERLY RD
SAINT LOUIS, MO 63128
ORTIZ-ARROYO, IRMA
12700 SOUTHFORK RD
SAINT LOUIS, MO 63128
WANG, LAWRENCE
10004 KENNERLY RD
ST. LOUIS, MO 63128
SCULLIN, KRISTEN
12348 OLD TESSON RD
SAINT LOUIS, MO 63128
RUP, DIANE
13065 OLD TESSON FERRY RD
SAINT LOUIS, MO 63128
PERSCHBACHER, JAMES
10012 KENNERLY RD
SAINT LOUIS, MO 63128
CALCATERRA, CURT
5034 GRIFFIN RD
SAINT LOUIS, MO 63128
GOURTZELIS, NICHOLAS
10004 KENNERLY RD
ST LOUIS, MO 63128
MWINTSHI, KABEYA
10004 KENNERLY RD
SAINT LOUIS, MO 63128
ANDERSON, GEORGE
4116 VON TALGE RD
SAINT LOUIS, MO 63128
DISCH, DENNIS
10012 KENNERLY RD
SAINT LOUIS, MO 63128
Details
MICHAEL FIGURA, DPM
Phone Number
(314) 894-3761
Office Locations
4105 UNION RD
SAINT LOUIS, MO 63129
4105 UNION RD SAINT LOUIS MO, 63129

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