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UnitedHealthcare MedicareDirect Patriot (PFFS) H5435-001 is a 2023 Medicare Advantage Plan or Part-C by UnitedHealthcare available to residents in Wyoming and Nebraska. This plan does not provide extra prescription drug (Part-D) coverage. UnitedHealthcare UnitedHealthcare MedicareDirect Patriot (PFFS) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay
$- out-of-pocket. This can be an extremely nice safety net.
UnitedHealthcare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for UnitedHealthcare MedicareDirect Patriot (PFFS) you still retain Original Medicare. But you will get extra Part A (Hospital Insurance)
and Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all
the benefits of Original Medicare from UnitedHealthcare except hospice care. Original Medicare still provides you with hospice care if you sign up for
Medicare Advantage in Wyoming or Medicare Advantage in Nebraska.
What type of plan is UnitedHealthcare MedicareDirect Patriot (PFFS)
UnitedHealthcare MedicareDirect Patriot (PFFS) is a PFFS *. A Private Fee-For-Service (PFFS) plan is a Medicare Advantage (MA) health plan offered by a contract with the Centers for Medicare & Medicaid Services (CMS) to provide you with benefits. UnitedHealthcare (instead of Medicare) will decide on how much it will cover and how much you will pay for the services you get. You may go to any Medicare approved doctor or hospital or any other health care provider that accepts both Medicare and your plans payment. A PFFS plan has no provider network, and you dont need a referral or a primary care physician for any health care or services. PFFS plans are the most flexible but a doctor will make a visit-by-visit decisions on whether to accept your provider.
How much does UnitedHealthcare MedicareDirect Patriot (PFFS) cost?
Part-C Premium
A monthly premium is the fee you pay to the plan in exchange for coverage. UnitedHealthcare charges a $0 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.
2023 Summary of Benefits
The benefit information provided is a summary of what UnitedHealthcare MedicareDirect Patriot (PFFS) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from UnitedHealthcare helps
get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.
Is UnitedHealthcare MedicareDirect Patriot (PFFS) a good plan? UnitedHealthcare MedicareDirect Patriot (PFFS) received a 3 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance.
Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures. You can use the CMS star rating to compare UnitedHealthcare MedicareDirect Patriot Reviews among several different plans.
2022 Overall Rating
Part C Summary Rating
Part-D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing
Staying Healthy, Screening, Testing, & Vaccines
Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Monitoring Physical Activity
Managing Chronic And Long Term Care for Older Adults
Total Rating
SNP Care Management
Medication Review
Pain Assessment
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Controlling Blood Pressure
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy
Member Experience with H5435-001 Health Plan
Total Experience Rating
Getting Needed Care
Getting Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination
Member Complaints and Changes in Plans Performance
Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement
Health Plan Customer Service Rating for UnitedHealthcare
Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language
Drug Plan Customer Service Ratings
Total Rating
Call Center, TTY, Foreign Language
Ratings For Member Complaints and Changes in the Drug Plans Performance
Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement
Member Experience with the Drug Plan
Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs
Drug Safety and Accuracy of Drug Pricing
Total Rating
MPF Price Accuracy
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes
Coverage Area
(Click county or state to compare all available Advantage plans)
The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for UnitedHealthcare MedicareDirect Patriot (PFFS) requires you to live in that plan’s service area. The service area is listed below:
How much does UnitedHealthcare MedicareDirect Patriot (PFFS) cost?
UnitedHealthcare charges a $0 monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
How much is UnitedHealthcare MedicareDirect Patriot (PFFS) MOOP?
The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. UnitedHealthcare MedicareDirect Patriot (PFFS) by UnitedHealthcare MOOP is $-. Once you spend $- you will pay nothing for Part A or Part B covered services.
What type of plan is UnitedHealthcare MedicareDirect Patriot (PFFS)?
UnitedHealthcare MedicareDirect Patriot (PFFS) is a PFFS *. A Private Fee-For-Service (PFFS) is a plan offered by a contract with the (CMS) to provide you with benefits. PFFS plans are the most flexible but your doctor will make a visit-by-visit decisions on whether to accept your provider.
Is UnitedHealthcare MedicareDirect Patriot (PFFS) a good plan?
UnitedHealthcare MedicareDirect Patriot (PFFS) received a 3 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance.
Notes: Data are subject to change as contracts are finalized. For 2023, enhanced alternative may offer extra cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Site Search:
MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.
Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.
Every year, Medicare evaluates plans based on a 5-star rating system.
