AARP MedicareComplete 1 (HMO)

Medicare Advantage Plan for Vermont

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH1944-18-0
CMS Rating1
Plan TypeHMO
Annual Deductible$275.00

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
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$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
$395 for days 1 through 4
$0 for days 5 through 90
$0 for days 91 and beyond
Outpatient hospital coverage
$375 per visit
Doctor visits
Primary:
$20 per visit
Specialist:
$45 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$80 per visit (always covered)
Urgent care:
$30-40 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
20%
Lab services:
$2
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
$13
Mental health services
$395 for days 1 through 4
$0 for days 5 through 90
Outpatient group therapy visit with a psychiatrist:
$30
Outpatient individual therapy visit with a psychiatrist:
$40
Outpatient group therapy visit:
$30
Outpatient individual therapy visit:
$40
Skilled Nursing Facility
$0 for days 1 through 20
$160 for days 21 through 62
$0 for days 63 through 100
Rehabilitation services
Occupational therapy visit:
$40
Physical therapy and speech and language therapy visit:
$40
Ambulance
$250
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
$45
Routine foot care:
$45
Medical equipment/supplies
Durable 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 drugs
Chemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for AARP MedicareComplete 1 (HMO)

StateVermont
CountyChittenden

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$3 copayNot offered
Tier 2: Non-Preferred GenericNot offered$10 copayNot offered
Tier 3: Preferred Brand NameNot offered$47 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$95 copayNot offered
Tier 5: Specialty TierNot offered27% 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$141 copay$131 copay
Tier 4: Non-Preferred Brand NameNot offered$285 copay$275 copay
Tier 5: Specialty TierNot offered27% coinsurance27% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

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

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

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

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

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

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

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

Physician Finder

Physicians that accept AARP MedicareComplete 1 (HMO) for Vermont

/
GREEN, CURTIS
111 COLCHESTER AVE
BURLINGTON, VT 05401
STRANGE, MAYA
1 S. PROSPECT ST., ARNOLD 3
BURLINGTON, VT 05401
FRENZEN, SETH
6 SAN REMO DR.
S. BURLINGTON, VT 05401
BERNS, STEPHEN
111 COLCHESTER AVE
BURLINGTON, VT 05401
JINDAL, MOHIT
111 COLCHESTER AV
BURLINGTON, VT 05401
NOYES, CINDY
111 COLCHESTER AVE
BURLINGTON, VT 05401
RUSSO, ELIZABETH
111 COLCHESTER AVE
BURLINGTON, VT 05401
BARNARD, DIANA
111 COLCHESTER AVE
BURLINGTON, VT 05401
JEWELL, RYAN
111 COLCHESTER AVE
BURLINGTON, VT 05401
THOMPSON, NATHANIEL
111 COLCHESTER AVE
BURLINGTON, VT 05401
LOBEL, ROBERT
111 COLCHESTER AVE
BURLINGTON, VT 05401
BLAKE, KIMBERLY
96 COLCHESTER AVE
BURLINGTON, VT 05401
BELLOMO, STEPHANIE
789 PINE ST
BURLINGTON, VT 05401
CLIFFORD, PATRICK
96 COLCHESTER AVE
BURLINGTON, VT 05401
PENNEY, ROBERT
789 PINE ST
BURLINGTON, VT 05401
MAHONEY, ANDREW
111 COLCHESTER AVE
BURLINGTON, VT 05401
BISANZO, MARK
111 COLCHESTER AVE.
BURLINGTON, VT 05401
TOEDT-PINGEL, IRIS
111 COLCHESTER AVE
BURLINGTON, VT 05401
ELDAKAR-HEIN, SHADEN
111 COLCHESTER AVE
BURLINGTON, VT 05401
WALSH, KATHERINE
111 COLCHESTER AVE
BURLINGTON, VT 05401
MURPHY, TRACY
111 COLCHESTER AVE
BURLINGTON, VT 05401
ADAMS, DAVID
617 RIVERSIDE AVE
BURLINGTON, VT 05401
IRWIN, BRIAN
111 COLCHESTER AVE. ACC/ EP5
BURLINGTON, VT 05401
GAGNE, HAVALEH
111 COLCHESTER AVE
BURLINGTON, VT 05401
RIMASH, TAMARA
111 COLCHESTER AVE
BURLINGTON, VT 05401
Details
CURTIS GREEN, MD
Phone Number
(802) 847-3592
Office Locations
111 COLCHESTER AVE
BURLINGTON, VT 05401
111 COLCHESTER AVE BURLINGTON VT, 05401

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