2019 AARP MedicareComplete Plan 1 (HMO) H4527-037-000 in TX from UnitedHealthcare | HealthPocket

AARP MedicareComplete Plan 1 (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH4527-037-000
Plan Year2019
CMS Rating
Plan TypeHMO
Annual Deductible$125.00
Out-of-Pocket Maximum3400

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2021. see plan

Why We Like This Plan
  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • was the 4th best selling plan in El Paso in 2021

Costs and Other Important Information

Plan Year2019
Monthly Health Plan Premium$0.00
Monthly Drug Plan Premium$0.00
Health Plan Deductible$0
Other health plan deductibles?No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$3,400 In-network
Optional Supplemental BenefitsYes

Benefits

SERVICECOST
Inpatient hospital coverage$350 per stay
$0 per day for days 91 and beyond
Outpatient hospital coverage$200 per visit
Doctor visitsPrimary:$0 copay
Specialist:$40 per visit
Preventive care$0 copay
Emergency care/Urgent careEmergency:$90 per visit (always covered)
Urgent care:$30-40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:20%
Lab services:$7
Diagnostic radiology services (e.g., MRI):20%
Outpatient x-rays:$14
Mental health servicesInpatient hospital - psychiatric:$350 per stay
Outpatient group therapy visit with a psychiatrist:$40
Outpatient individual therapy visit with a psychiatrist:$40
Outpatient group therapy visit:$40
Outpatient individual therapy visit:$40
Skilled Nursing Facility$0 per day for days 1 through 20
$160 per day for days 21 through 42
$0 per day for days 43 through 100
Rehabilitation servicesOccupational therapy visit:$40
Physical therapy and speech and language therapy visit:$40
Ground ambulance$250
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:$40
Routine foot care:$40There may be limits on how much the plan will provide.
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):20% per item
Prosthetics (e.g., braces, artificial limbs):20% per item
Diabetes supplies:$0 per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:20%
Other Part B drugs:20%

Benefits Services

Hearing
Hearing exam$0 copay
Fitting/evaluationNot covered
Hearing aids$300-2,025There may be limits on how much the plan will provide.
Preventive Dental
Oral exam$0 copay. There may be limits on how much the plan will provide.
Cleaning$0 copay. There may be limits on how much the plan will provide.
Fluoride treatmentNot covered
Dental x-ray(s)$0 copay. There may be limits on how much the plan will provide.
Comprehensive Dental
Non-routine servicesNot covered
Diagnostic servicesNot covered
Restorative servicesNot covered
EndodonticsNot covered
PeriodonticsNot covered
ExtractionsNot covered
Prosthodontics, other oral/maxillofacial surgery, other servicesNot covered
Vision
Routine eye exam$0 copay. There may be limits on how much the plan will provide.
OtherNot covered
Contact lensesNot covered
Eyeglasses (frames and lenses)Not covered
Eyeglass framesNot covered
Eyeglass lensesNot covered
UpgradesNot covered

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$3 copayNot offered
Tier 2: GenericNot offereds$14 copayNot offered
Tier 3: Preferred BrandNot offereds$47 copayNot offered
Tier 4: Non-Preferred DrugNot offereds$100 copayNot offered
Tier 5: Specialty TierNot offereds30% coinsuranceNot offered

90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$9 copay$0 copay
Tier 2: GenericNot offereds$42 copay$0 copay
Tier 3: Preferred BrandNot offereds$141 copay$131 copay
Tier 4: Non-Preferred DrugNot offereds$300 copay$290 copay
Tier 5: Specialty TierNot offereds30% coinsurance30% coinsurance

Physicians that accept AARP MedicareComplete 1 (HMO) for Texas

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Huma, Lodhi
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Maria, Cardenas
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Patricia, Azarcon-samonte
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Thomas, Hoffer
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Nathaniel, Griffith
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Ajai, Agarwal
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Victor, Songbandith
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Kathleen, Robertson
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James, Cole
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Femi, Iwaloye
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Carlos, Gonzalez-sandoval
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Richard, Guerrero
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Carlos, Velez
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Andres, Aristizabal-ortiz
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Anwar, Monroy
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Arturo, Hernandez
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John, Patterson
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Huma Lodhi, M.D.
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  • Phone Number
    (915) 225-3807
  • Office Locations
    11351 James Watt Dr
    El Paso, TX 79936
11351 James Watt Dr El Paso TX, 79936

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HealthPocket.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.