UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) By UnitedHealthcare
UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) is a 2022 Medicare Advantage Special Needs Plan plan by UnitedHealthcare. This plan from UnitedHealthcare works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) H3256-001 is a Dual Eligible Special Needs Plan (D-SNP). A Dual Eligible SNP is for beneficiaries who are eligible for both Medicare and Medicaid. If you have Medicare and get help from Medicaid you can join any Medicare SNP you qualify for or switch plans at any time.
2022 Medicare Special Needs Plan Details
| Plan Name: | UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) |
|---|---|
| Plan ID: | H3256-001 |
| Special Needs Type: | Dual-Eligible |
| Provider: | UnitedHealthcare |
| Plan Year: | 2022 |
| Plan Type: | Local PPO |
| Monthly Premium C+D: | $32.40 |
| Part C Premium: | $0.00 |
| Part D (Drug) Premium: | $32.40 |
| Part D Supplemental Premium | $0.00 |
| Total Part D Premium: | $32.40 |
| Drug Deductible: | $480.00 |
| Tiers with No Deductible: | 0 |
| Benchmark: | below the regional benchmark |
| Type of Medicare Health Plan: | Defined Standard Benefit |
| Drug Benefit Type: | Basic | Gap Coverage: | No Gap Coverage |
The UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) H3256-001 is available to residents in Georgia, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) is a Local PPO. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.
Gap Coverage
In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. This UnitedHealthcare plan offer additional coverage through the gap.
UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) Part-C Premium
UnitedHealthcare plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H3256-001 Part-D Deductible and Premium
UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) has a monthly drug premium of $32.40 and a $480.00 drug deductible. This UnitedHealthcare plan offers a $32.40 Part D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by UnitedHealthcare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $32.40 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
UnitedHealthcare Gap Coverage
In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This UnitedHealthcare plan offer additional coverage through the gap.
Premium Assistance
The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) medicare insurance offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $8.10 for 75% low income subsidy $16.20 for 50% and $24.30 for 25%.
| Full LIS Premium: | $0.00 |
|---|---|
| 75% LIS Premium: | $8.10 |
| 50% LIS Premium: | $16.20 |
| 25% LIS Premium: | $24.30 |
H3256-001 Formulary or Drug Coverage
UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 UnitedHealthcare Dual Complete Choice LP (PPO D-SNP) H3256-001 Formulary here.
| Drug Tier | Copay Preferred Pharmacy |
Copay Nonpreferred Pharmacy |
|---|---|---|
| Tier 1 | NA | $0 |
| Tier 2 | NA | $0 |
| Tier 3 | NA | $0 |
| Tier 4 | NA | $0 |
| Tier 5 | NA | $0 |
Coverage Area for UnitedHealthcare Dual Complete Choice LP (PPO D-SNP)
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Medicare Plans in Georgia| County: | |
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Source: CMS.
Plans as of September 1, 2021.
Notes: Data are subject to change. All contracts for 2022 have not been finalized. For 2022, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.
Includes 2022 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.