UnitedHealthcare Dual Complete RP (Regional PPO SNP)

Medicare Advantage Plan for North Carolina

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDR1548-1-0
CMS RatingNot Rated1
Plan TypeRegional PPO 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)
$10,000 In and Out-of-network $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
In-Network:
$0 copay
Out-of-Network:
40% per stay
Outpatient hospital coverage
In-Network:
$0 copay
Out-of-Network:
40% per visit
Doctor visits
Primary:
In-Network:
$0 copay
Out-of-Network:
40% per visit
Specialist:
In-Network:
$0 copay
Out-of-Network:
40% per visit
Preventive care
In-Network:
$0 copay
Out-of-Network:
0-40%
Emergency care/Urgent care
Emergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
In-Network:
$0 copay
Out-of-Network:
40%
Lab services:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Diagnostic radiology services (e.g., MRI):
In-Network:
$0 copay
Out-of-Network:
40%
Outpatient x-rays:
In-Network:
$0 copay
Out-of-Network:
40%
Mental health services
In-Network:
$0 copay
Out-of-Network:
40% per stay
Outpatient group therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
40%
Outpatient individual therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
40%
Outpatient group therapy visit:
In-Network:
$0 copay
Out-of-Network:
40%
Outpatient individual therapy visit:
In-Network:
$0 copay
Out-of-Network:
40%
Skilled Nursing Facility
In-Network:
$0 copay
Out-of-Network:
40% per stay
Rehabilitation services
Occupational therapy visit:
In-Network:
$0 copay
Out-of-Network:
40%
Physical therapy and speech and language therapy visit:
In-Network:
$0 copay
Out-of-Network:
40%
Ambulance
In-Network:
$0 copay
Out-of-Network:
20%
Transportation
In-Network:
$0 copay
Out-of-Network:
75%
Foot care (podiatry services)
Foot exams and treatment:
In-Network:
$0 copay
Out-of-Network:
40%
Routine foot care:
In-Network:
$0
Out-of-Network:
40%
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
In-Network:
$0 copay
Out-of-Network:
40% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:
$0 copay
Out-of-Network:
40% per item
Diabetes supplies:
In-Network:
$0 copay
Out-of-Network:
40% per item
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
In-Network:
$0 copay
Out-of-Network:
30%
Other Part B drugs:
In-Network:
$0 copay
Out-of-Network:
30%

Coverage Area for UnitedHealthcare Dual Complete RP (Regional PPO SNP)

StateNorth Carolina
CountyCabarrus

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 RP (Regional PPO SNP) for North Carolina

/
KILBANE, SHEILA
8605 CLIFF CAMERON DR
CHARLOTTE, NC 28269
HARSCH, RICHARD
2090 HWY 29 SOUTH
CHINA GROVE, NC 28023
CONROY, ROSOLENA
10220 PROSPERITY PARK DR STE 300
CHARLOTTE, NC 28269
BRANDON, ROCHELLE
4409 RANCLIFFE CT
CHARLOTTE, NC 28269
MAENPAA, GARATH
5727 PROSPERITY CROSSING DRIVE
CHARLOTTE, NC 28269
MORGAN, AMY
10220 PROSPERITY PARK DR STE 300
CHARLOTTE, NC 28269
FREEMAN, KEVIN
5727 PROSPERITY CROSSING DR.
CHARLOTTE, NC 28269
RUPE, CAROL
3230 PROSPERITY CHURCH RD
CHARLOTTE, NC 28269
KALLEBERG, KARI
5727 PROSPERITY CROSSING DR.
CHARLOTTE, NC 28269
KNUTSON, HEATHER
5727 PROSPERITY CROSSING DR.
CHARLOTTE, NC 28269
TAKAHASHI, REBECCA
5727 PROSPERITY CROSSING DR.
CHARLOTTE, NC 28269
HILLMAN, VINCENT
10616 METROMONT PKWY
CHARLOTTE, NC 28269
LESTER, SUSAN
5727 PROSPERITY CROSSING DRIVE
CHARLOTTE, NC 28269
TEDROW, UMPAI
7004 SMITH CORNERS BLVD
CHARLOTTE, NC 28269
BARNES, AJIRI
5727 PROSPERITY CROSSING DRIVE
CHARLOTTE, NC 28269
BEAN, MICHAEL
10220 PROSPERITY PARK DR STE 300
CHARLOTTE, NC 28269
GOODMAN, SARAH
10220 PROSPERITY PARK RD
CHARLOTTE, NC 28269
PAUL, JONATHAN
10616 METROMONT PKWY
CHARLOTTE, NC 28269
SHULSTAD, ANDREW
10220 PROSPERITY PARK DR STE 300
CHARLOTTE, NC 28269
WOLYNIAK, JOSEPH
7004 SMITH CORNERS BLVD
CHARLOTTE, NC 28269
WATSON, PIERCE
4458 ANTELOPE LN
CHARLOTTE, NC 28269
MADSEN, CHRISTIAN
9200 WEST WT HARRIS BOULEVARD
CHARLOTTE, NC 28269
SIDDIQUI, HUMA
8601 UNIVERSITY EAST DRIVE
CHARLOTTE, NC 28213
HENSON, GALA
251 EASTWAY DR
CHARLOTTE, NC 28213
JAMES, FELICE
251 EASTWAY DR
CHARLOTTE, NC 28213
Details
SHEILA KILBANE, MD
Phone Number
(704) 548-9947
Office Locations
8605 CLIFF CAMERON DR
CHARLOTTE, NC 28269
8605 CLIFF CAMERON DR CHARLOTTE NC, 28269

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