2020 Erickson Advantage Liberty without Drugs (HMO) H5652-002-000 in CO from UnitedHealthcare

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Insurance Type	Medicare Advantage Plan (Part C)
Insurance Provider	UnitedHealthcare
Plan ID	H5652-002-000
Plan Year	2020
CMS Rating
Plan Type	HMO
Annual Deductible	$0.00
Out-of-Pocket Maximum	6700

What To Know About This Plan	This is a health coverage only plan with no drug coverage This plan is available for 2021. see plan

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

Premium
Total monthly premium	$0.00
Health plan premium	$0.00
Standard Part B premium	$135.50
Part B premium reduction	No
Deductible
Health plan deductible	$800 In-network
Estimated yearly costs
Estimated total yearly costs for care	$6,894.00
Out-of-pocket max
Out-of-pocket max	$6,700 In-network

Doctor services
Primary doctor visit	$20-30 per visit
Specialist visit	$50 per visit
Tests, labs, & imaging
Diagnostic tests & procedures	$0 copay
Lab services	$10
Diagnostic radiology services (like MRI)	$0-100
Outpatient x-rays	$20
Emergency care	$90 per visit (always covered)
Urgent care	$30 per visit (always covered)
Hospital services
Inpatient hospital coverage	$300 per day for days 1 through 7 $0 per day for days 8 through 90 $0 per day for days 91 and beyond
Outpatient hospital coverage	$0-300 per visit
Skilled nursing facility
Skilled nursing facility	$0 per day for days 1 through 20 $178 per day for days 21 through 58 $0 per day for days 59 through 100
Preventive services
Preventive services	$0 copay
Ambulance
Ground ambulance	$250
Therapy services
Occupational therapy visit	$40
Physical therapy & speech & language therapy visit	$40
Mental health services
Outpatient group therapy with a psychiatrist	$30
Outpatient individual therapy with a psychiatrist	$30
Outpatient group therapy visit	$0 copay
Outpatient individual therapy visit	$0-30
Opioid treatment services
Opioid treatment services	Covered
Other services
Durable medical equipment (like wheelchairs & oxygen)	20% per item
Prosthetics (like braces, artificial limbs)	20% per item
Diabetes supplies	20% per item

Hearing
Hearing exam	$0 copay
Fitting/evaluation	Not covered
Hearing aids - All types	$375-2,075
Preventive dental
Oral exam	$0 copay
Cleaning	$0 copay
Fluoride treatment	$0 copay
Dental x-rays	$0 copay
Comprehensive dental
Non-routine services	Not covered
Diagnostic services	Not covered
Restorative services	Not covered
Endodontics	Not covered
Periodontics	Not covered
Extractions	Not covered
Prosthodontics, other oral/maxillofacial surgery, other services	Not covered
Vision
Routine eye exam	$0 copay
Contact lenses	$0 copay
Eyeglasses (frames & lenses)	$0 copay
Eyeglass frames (only)	Not covered
Eyeglass lenses (only)	Not covered
Upgrades	Not covered
More benefits
Transportation services for non-emergency care: Any health-related locations	Not covered
Transportation services for non-emergency care: Plan-approved locations	Limited coverage
Over the counter drug benefits	Not covered
Meals for short duration	Not covered
Annual physical exams	Limited coverage
Telehealth	Not covered

Part B drugs
Chemotherapy drugs	10%
Other Part B drugs	10%

Erickson Advantage Liberty without Drugs (HMO)

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Plan Details

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Benefits & costs

Extra benefits & costs

Drug coverage & costs

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Staying healthy - screenings, tests and vaccines

Managing Chronic Conditions

Member Experience with Health Plan

Member Complaints, and Changes in Health Plan's Performance

Health Plan Customer Service

Drug Plan Customer Service

Member Complaints, and Changes in Drug Plan's Performance

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Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

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	Not Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure	Not Rated
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Getting needed care
Getting appointments and care quickly	Not Rated
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Plan makes timely decision about appeals
Reviewing appeals decisions	Not Rated
Call center – foreign language interpreter and TTY/TDD availability - Medical	Not Rated

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

Complaints about the drug plan	Not Rated
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate
Statin Use in Persons with Diabetes	Not Rated

Erickson Advantage Liberty without Drugs (HMO)

Benefits & Coverage

Plan Details

Overview

Benefits & costs

Extra benefits & costs

Drug coverage & costs

CMS Ratings

Staying healthy - screenings, tests and vaccines

Managing Chronic Conditions

Member Experience with Health Plan

Member Complaints, and Changes in Health Plan's Performance

Health Plan Customer Service

Drug Plan Customer Service

Member Complaints, and Changes in Drug Plan's Performance

Member Experience with Drug Plan

Drug Pricing and Patient Safety

Physician Finder

Similar Plans

Related Articles

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Types of Health Insurance

Health Insurance

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Medicare Plans Found