2018 AARP MedicareComplete Value (HMO) H5253-034-000 in WI from UnitedHealthcare | HealthPocket

AARP MedicareComplete Value (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderUnitedHealthcare
Plan IDH5253-034-000
Plan Year2018
CMS Rating
Plan TypeHMO
Annual Deductible$355.00
Out-of-Pocket Maximum5900

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2020. 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 2nd best selling plan in Milwaukee in 2020

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsYes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$5,900 In-network
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$0.00
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverage$395 for days 1 through 4
$0 for days 5 through 90
$0 for days 91 and beyond
Outpatient hospital coverage$395 per visit
Doctor visitsPrimary:
$15 per visit
Specialist:
$50 per visit
Preventive care$0 copay
Emergency care/Urgent careEmergency:
$80 per visit (always covered)
Urgent care:
$30-40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
20%
Lab services:
$2
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
$12
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 57
$0 for days 58 through 100
Rehabilitation servicesOccupational therapy visit:
$40
Physical therapy and speech and language therapy visit:
$40
Ambulance$275
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
$50
Routine foot care:
$50
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%

Coverage Area for AARP MedicareComplete Value (HMO)

StateWisconsin
CountyMilwaukee

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: Non-Preferred GenericNot offereds$14 copayNot offered
Tier 3: Preferred Brand NameNot offereds$47 copayNot offered
Tier 4: Non-Preferred Brand NameNot offereds$100 copayNot offered
Tier 5: Specialty TierNot offereds25% coinsuranceNot offered
Tier 6: Select Care Drugs

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: Non-Preferred GenericNot offereds$42 copay$0 copay
Tier 3: Preferred Brand NameNot offereds$141 copay$131 copay
Tier 4: Non-Preferred Brand NameNot offereds$300 copay$290 copay
Tier 5: Specialty TierNot offereds25% coinsurance25% coinsurance
Tier 6: Select Care Drugs

Physicians that accept AARP MedicareComplete Value (HMO) for Wisconsin

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Patricia, Cabral
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John, Hanson
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Moises, Garcia
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Harrison, Pitcher
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Gregory, Warren
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John, Hall
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Arshad, Jahangir
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Bruce, Hlodnicki
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Joseph, Kroner
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Mengyao, Liang
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Fabiana, Kotovicz
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Kjersti, Knox
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Karrie, Lu
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Matthew, Krzemienski
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Asad, Ghafoor
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Ayman, Gheith
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Midwest Anesthesia Consultants Sc
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Bhupendra, Khatri
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Amin, Kassam
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Imran, Niazi
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Patricia Cabral, M.D.
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  • Phone Number
    (414) 672-1353
  • Office Locations
    2906 S 20th St
    Milwaukee, WI 53215
2906 S 20th St Milwaukee WI, 53215

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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).