2020 WellCare Advance (HMO) H4868-3-0 in NY from Universal American | HealthPocket

WellCare Advance (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C)
Insurance ProviderUniversal American
Plan IDH4868-3-0
Plan Year2020
CMS RatingNot Rated
Plan TypeHMO
Annual Deductible$0.00
Out-of-Pocket Maximum6700

What To Know About This Plan
  • This is a health coverage only plan with no drug coverage

Why We Like This Plan
  • has no additional premium costs outside of your Medicare Part B premium

Overview

Premium
Total monthly premium$0.00
Health plan premium$0.00
Standard Part B premium$135.50
Part B premium reductionNo
Deductible
Health plan deductible$0
Estimated yearly costs
Estimated total yearly costs for care$6,678.00
Out-of-pocket max
Out-of-pocket max$6,700 In-network

Benefits & costs

Doctor services
Primary doctor visit$10 per visit
Specialist visit$35 per visit
Tests, labs, & imaging
Diagnostic tests & procedures$0-50
Lab services$0 copay
Diagnostic radiology services (like MRI)$0-75
Outpatient x-rays$0
Emergency care$90 per visit (always covered)
Urgent care$25 per visit (always covered)
Hospital services
Inpatient hospital coverage$300 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage20% per visit
Skilled nursing facility
Skilled nursing facility$0 per day for days 1 through 20
$164.50 per day for days 21 through 100
Preventive services
Preventive services$0 copay
Ambulance
Ground ambulance$285
Therapy services
Occupational therapy visit$35
Physical therapy & speech & language therapy visit$35
Mental health services
Outpatient group therapy with a psychiatrist$40
Outpatient individual therapy with a psychiatrist$40
Outpatient group therapy visit$40
Outpatient individual therapy visit$40
Opioid treatment services
Opioid treatment servicesCovered
Other services
Durable medical equipment (like wheelchairs & oxygen)20% per item
Prosthetics (like braces, artificial limbs)20% per item
Diabetes supplies$0 per item

Extra benefits & costs

Hearing
Hearing exam$35
Fitting/evaluation$0 copay
Hearing aids - All types$0 copay
Preventive dental
Oral exam$0 copay
Cleaning$0 copay
Fluoride treatment$0 copay
Dental x-rays$0 copay
Comprehensive dental
Non-routine servicesNot covered
Diagnostic services$0 copay
Restorative services$0 copay
Endodontics$0 copay
Periodontics$0 copay
Extractions$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services$0 copay
Vision
Routine eye exam$0 copay
Contact lenses$0 copay
Eyeglasses (frames & lenses)$0 copay
Eyeglass frames (only)$0 copay
Eyeglass lenses (only)$0 copay
UpgradesNot covered
More benefits
Fitness benefitLimited coverage
Over the counter drug benefitsNot covered
In-home support servicesNot covered
Routine chiropractic serviceLimited coverage
Home and bathroom safety devicesNot covered
Meals for short durationNot covered
Annual physical examsLimited coverage
TelehealthNot covered

Drug coverage & costs

Part B drugs
Chemotherapy drugs20%
Other Part B drugs20%

Coverage Area for WellCare Advance (HMO)

StateNew York
CountyKings

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 abilityNot Rated
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain assessment
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Rheumatoid arthritis management
Reducing the risk of fallingNot Rated
Improving bladder controlNot Rated
Medication reconciliation post-discharge
Plan all-cause readmissions
Statin Therapy for Patients with Cardiovascular Disease

Member Experience with Health Plan

Getting needed careNot Rated
Getting appointments and care quicklyNot Rated
Customer serviceNot Rated
Rating of health care qualityNot Rated
Rating of health 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
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 - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forwardNot Rated
Appeals upheldNot Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug planNot Rated
Members choosing to leave the drug planNot 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 Accuracy
Medication adherence for diabetes medicationsNot Rated
Medication adherence for hypertension - RAS antagonists
Medication adherence for cholesterol - Statins
MTM program completion rate for CMRNot Rated
Statin use in persons with diabetes - SUPDNot Rated

Physicians that accept WellCare Advance (HMO) for New York

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Louis, Vital
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Walter, Perez
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Victor, Sharobeem
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Rubin Brecher Md Llc
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Nicola, Jacobucci
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Fred, Montas
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David, Sussman
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David, Kessler
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South Elliot South Portland Medical Comprehensive Medical Center
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Cary, English
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Erroll, Byer
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Albina, Chua
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Franck, Leveille
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Theodore, Avruskin
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Rajiv, Saini
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Herman, Rosenberg
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Olanrewaju, Adeosun
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James, Einhorn
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Ali, Zaidi
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Kathy, Man-wong
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George, Martin
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Jeffrey, Shoub
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Barbara, Haralson
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Mikhail, Grabovetsky
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Michael, Banker
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Louis Vital, MD
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  • Phone Number
    (718) 693-4900
  • Office Locations
    3223 Church Avenue
    Brooklyn, NY 11226
3223 Church Avenue Brooklyn NY, 11226
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Medicare Plans Found

 

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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).