2018 AARP MedicareComplete Choice (Regional PPO) R5329-1-0 in NH from UnitedHealthcare | HealthPocket

AARP MedicareComplete Choice (Regional PPO)

$972/mo

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Zip Code03103
Applicant10/22/1983 Male
Coverage Start10/24/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDR5329-1-0
Plan Year2018
CMS RatingNot Rated
Plan TypeRegional PPO
Annual Deductible$0.00

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 $3,500 In-network
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$19.10
Monthly Health Plan Premium$61.90

Benefits

SERVICECOST
Inpatient hospital coverageIn-Network:
$225 for days 1 through 7
$0 for days 8 through 90
$0 for days 91 and beyond
Out-of-Network:
$225 for days 1 through 7
$0 for days 8 and beyond
Outpatient hospital coverageIn-Network:
$200 per visit
Out-of-Network:
$200 per visit
Doctor visitsPrimary:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Specialist:
In-Network:
$25 per visit
Out-of-Network:
$25 per visit
Preventive careIn-Network:
$0 copay
Out-of-Network:
$0 copay
Emergency care/Urgent careEmergency:
$80 per visit (always covered)
Urgent care:
$25-40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
In-Network:
20%
Out-of-Network:
20%
Lab services:
In-Network:
$5
Out-of-Network:
$5
Diagnostic radiology services (e.g., MRI):
In-Network:
$100
Out-of-Network:
$100
Outpatient x-rays:
In-Network:
$14
Out-of-Network:
$14
Mental health servicesIn-Network:
$225 for days 1 through 7
$0 for days 8 through 90
Out-of-Network:
$225 for days 1 through 7
$0 for days 8 through 90
Outpatient group therapy visit with a psychiatrist:
In-Network:
$30
Out-of-Network:
$30-40
Outpatient individual therapy visit with a psychiatrist:
In-Network:
$40
Out-of-Network:
$30-40
Outpatient group therapy visit:
In-Network:
$30
Out-of-Network:
$30-40
Outpatient individual therapy visit:
In-Network:
$40
Out-of-Network:
$30-40
Skilled Nursing FacilityIn-Network:
$0 for days 1 through 20
$160 for days 21 through 42
$0 for days 43 through 100
Out-of-Network:
$0 for days 1 through 20
$160 for days 21 through 42
$0 for days 43 through 100
Rehabilitation servicesOccupational therapy visit:
In-Network:
$25
Out-of-Network:
$25
Physical therapy and speech and language therapy visit:
In-Network:
$25
Out-of-Network:
$25
AmbulanceIn-Network:
$250
Out-of-Network:
$250
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
In-Network:
$25
Out-of-Network:
$25
Routine foot care:
In-Network:
$25
Out-of-Network:
$25
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
In-Network:
20% per item
Out-of-Network:
50% per item
Prosthetics (e.g., braces, artificial limbs):
In-Network:
20% per item
Out-of-Network:
20% per item
Diabetes supplies:
In-Network:
$0 copay
Out-of-Network:
20% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
In-Network:
20%
Out-of-Network:
20%
Other Part B drugs:
In-Network:
20%
Out-of-Network:
20%

Coverage Area for AARP MedicareComplete Choice (Regional PPO)

StateNew Hampshire
CountyBelknap

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$3 copayNot offered
Tier 2: Non-Preferred GenericNot offered$10 copayNot offered
Tier 3: Preferred Brand NameNot offered$45 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$95 copayNot offered
Tier 5: Specialty TierNot offered33% coinsuranceNot offered

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$9 copay$0 copay
Tier 2: Non-Preferred GenericNot offered$30 copay$0 copay
Tier 3: Preferred Brand NameNot offered$135 copay$125 copay
Tier 4: Non-Preferred Brand NameNot offered$285 copay$275 copay
Tier 5: Specialty TierNot offered33% coinsurance33% coinsurance

Staying healthy - screenings, tests and vaccines

Breast cancer screeningNot Rated
Colorectal cancer screeningNot Rated
Annual flu vaccineNot Rated
Improving or maintaining physical healthNot Rated
Improving or maintaining mental healthNot Rated
Monitoring physical abilityNot Rated
Adult BMI assessmentNot Rated

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain screeningNot Rated
Osteoporosis management in women who had a fractureNot Rated
Diabetes care – eye examNot Rated
Diabetes care – kidney disease monitoringNot Rated
Diabetes care – blood sugar controlledNot Rated
Controlling blood pressureNot Rated
Rheumatoid arthritis managementNot Rated
Reducing the risk of fallingNot Rated
Plan all-cause readmissionsNot Rated

Member Experience with Health Plan

Getting needed careNot Rated
Getting appointments and care quicklyNot Rated
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 problemsNot Rated
Health plan quality improvementNot Rated

Health Plan Customer Service

Plan makes timely decision about appealsNot Rated
Reviewing appeals decisionsNot Rated
Call center – foreign language interpreter and TTY/TDD availability - MedicalNot Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - DrugsNot Rated
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug planNot Rated
Members choosing to leave the drug planNot Rated
Beneficiary access and performance problemsNot Rated
Drug plan quality improvementNot Rated

Member Experience with Drug Plan

Rating of drug planNot Rated
Getting needed prescription drugsNot Rated

Drug Pricing and Patient Safety

MPF Price AccuracyNot Rated
High risk medicationNot Rated
Part D medication adherence for diabetesNot Rated
Part D medication adherence for hypertensionNot Rated
Part D medication adherence for cholesterolNot Rated
Medication Therapy Management program completion rate Not Rated

Physicians that accept AARP MedicareComplete Choice (Regional PPO) for New Hampshire

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Chase, Elizabeth
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Michaud, Marc
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Ginsberg, Martin
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Trautwein, Michael
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Jenkins, Morgan
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Scollan, Joey
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Cruz, Christopher
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Kotsinyan, Vahagn
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Jocson, Colleen
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Chopra, Alpana
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So, Raymond
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Jablonka, Marcio
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Rowe, Bryan
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Stapp, Brenna
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Lu, Daiying
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Lehouillier, Pia Marie
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Gacheri, Susan
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Fallon, Margaret
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Hartman-heaney, Tipton
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Snipes, Samuel
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Elizabeth Chase, MD
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  • Phone Number
    (603) 663-8200
  • Office Locations
    445 Cypress St
    Manchester, NH 03103
445 Cypress St Manchester NH, 03103

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