Welcome to UnitedHealthcare Community Plan.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments, and coinsurance may apply. Benefits may vary by county and plan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you may receive. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440, or go to www.uhcdualcomplete.com. This document is available in alternative formats. You must have both Medicare Parts A and B, and must reside in the service area of the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Your ability to enroll in a special needs plan is not limited to certain times of the year. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. HMO members must use plan providers except in emergency or urgent care situations or for Out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor UnitedHealthcare® Medicare Advantage plans will be responsible for the costs. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048, 24 hours a day, 7 days a week; the Social Security Office at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday, TTY: 1-800-325- 0778; or your state Medicaid office. By enrolling in an MA-PD you will automatically be disenrolled from any existing Medicare Prescription Drug coverage. To receive the highest level of benefit you must use contracted network pharmacies to access your prescription drug benefit except in the case of emergency. The pharmacy network includes retail, mail order, long-term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacy services. You may obtain your prescriptions from pharmacies outside the contracted network at a reduced benefit. Quantity limitations and restrictions may apply. For information about mail order, names and addresses of network pharmacies or for more information call 1-877-702-5110, or TTY 711, Monday through Friday, 8:00 a.m. to 8:00 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440, or go to www.uhcdualcomplete.com. The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed.

UNITEDHEALTHCARE PERSONAL CARE PLUS
UnitedHealthcare® Medicare Advantage plans are offered by UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. UnitedHealthcare Personal Care Plus® (HMO SNP) plan is special needs plans available to all people meeting certain eligibility requirements, such as having both Medical Assistance from the state and Medicare.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments, and coinsurance may apply. Benefits may vary by county and plan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you may receive. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. This document is available in alternative formats. You must have both Medicare Parts A and B, and must reside in the service area of the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Your ability to enroll in a special needs plan is not limited to certain times of the year. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. HMO members must use plan providers except in emergency or urgent care situations or for Out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor UnitedHealthcare® Medicare Advantage plans will be responsible for the costs. You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227), TTY: 1-877- 486-2048, 24 hours a day, 7 days a week; the Social Security Office at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday, TTY: 1-800-325-0778; or your state Medicaid office. By enrolling in an MA-PD you will automatically be disenrolled from any existing Medicare Prescription Drug coverage. To receive the highest level of benefit you must use contracted network pharmacies to access your prescription drug benefit except in the case of emergency. The pharmacy network includes retail, mail order, long term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacy services. You may obtain your prescriptions from pharmacies outside the contracted network at a reduced benefit. Quantity limitations and restrictions may apply. For information about mail order, names and addresses of network pharmacies or for more information call 1-877-702-5110, or TTY 711, Monday through Friday, 8:00 a.m. to 8:00 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed.

EVERCARE® PLANS
Evercare® Medicare Advantage plans are offered by UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. Evercare® Medicare Advantage plans are special needs plans available to all people meeting certain eligibility requirements, such as having both Medical Assistance from the state and Medicare.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments, and coinsurance may apply. Benefits may vary by county and plan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you may receive. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. This document is available in alternative formats. You must have both Medicare Parts A and B, and must reside in the service area of the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Your ability to enroll in a special needs plan is not limited to certain times of the year. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. HMO members must use plan providers except in emergency or urgent care situations or for Out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Evercare® Medicare Advantage plans will be responsible for the costs. For HMO-POS members, with the exception of emergency or urgent care or out-of-area renal dialysis, it may cost more to get care from out-of-network providers. [For PPO members, reimbursement is provided for all covered benefits regardless of whether they are received in-network. Out of network services may cost more than in-network services.] You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048, 24 hours a day, 7 days a week; the Social Security Office at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday, TTY: 1-800-325-0778; or your state Medicaid office. By enrolling in an MA-PD you will automatically be disenrolled from any existing Medicare Prescription Drug coverage. To receive the highest level of benefit you must use contracted network pharmacies to access your prescription drug benefit except in the case of emergency. The pharmacy network includes retail, mail order, long-term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacy services. You may obtain your prescriptions from pharmacies outside the contracted network at a reduced benefit. Quantity limitations and restrictions may apply. For information about mail order, names and addresses of network pharmacies or for more information call 1-877-702-5110 or TTY 711, Monday through Friday, 8:00 a.m. to 8:00 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed.

MASCO Pre-Enrollment
Evercare Senior Care Options is a voluntary MassHealth benefit in association with the Executive Office of Health and Human Services and CMS. Evercare Senior Care Options (Evercare SCO) is available to people who are 65 and older. You must be entitled to Medicare Part A and enrolled in Medicare Part B and MassHealth Standard to enroll in our Medicare Advantage Special Needs Plan. You also need to live in the service area. If you currently pay for a Part B premium, you must keep paying it. You can enroll in a special needs plan at any time. For more information contact Customer Service at 1-877-702-5110, 7 days a week, between 8:00 am and 8:00 pm local time. TTY users can call 711 or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440, or go to www.uhcdualcomplete.com.

Evercare SCO is a Coordinated Care plan with a Medicare Advantage contract and a contract with the Commonwealth of Massachusetts. To access benefits, you must have services provided or arranged by your primary care team. These services must be received from providers in the Evercare SCO network except in emergency or urgent care situations or for out-of-network renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Evercare SCO plan will be responsible for the costs. Evercare SCO is offered by UnitedHealth Insurance Company (UHIC). By enrolling in an MA-PD you will automatically be disenrolled from any existing Medicare Prescription Drug coverage. To receive the highest level of benefit you must use contracted network pharmacies to access your prescription drug benefit except in the case of emergency. The pharmacy network includes retail, mail order, long-term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacy services. You may obtain your prescription from pharmacies outside the contracted network at a reduced benefit. Quantity limitations and restrictions may apply. For information about mail order, names and addresses of network pharmacies or other pharmacy related information call 1-877-702-5110, 8 a.m. - 8 p.m. local time, 7 days a week (TTY users 711), or mail to UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440.

The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed. Premiums, copays, coinsurance and deductible may vary based on the level of Extra Help.

If you have MassHealth Standard, but you do not qualify for Medicare Part A and/or Medicare Part B, you may still be eligible to enroll in a MassHealth Senior Care Options (SCO) plan offered by UnitedHealthcare and receive all of your MassHealth benefits through our SCO program. Call our Customer Service department at 1-877-702-5110, TTY can call 711, 7 days a week, between 8:00 am and 8:00 pm local time, for additional information about the MassHealth SCO program.

SECUREHORIZONS® MEDICARE COMPLETE
SecureHorizons® Medicare Advantage plans are offered by UnitedHealthcare Insurance Company and its affiliated companies, a Medicare Advantage organization with a Medicare contract. SecureHorizons® Medicare Complete (HMO SNP) plan is a special needs plans available to all people meeting certain eligibility requirements, such as having both Medical Assistance from the state and Medicare.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Limitations, copayments, and coinsurance may apply. Benefits may vary by county and plan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you may receive. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. This document is available in alternative formats. You must have both Medicare Parts A and B, and must reside in the service area of the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Your ability to enroll in a special needs plan is not limited to certain times of the year. For more information, contact Customer Service at 1-877-702-5110, TTY: 711, 7 days a week, between 8 a.m. and 8 p.m. local time. HMO members must use plan providers except in emergency or urgent care situations or for Out-of-area renal dialysis. If you obtain routine care from out of-network providers neither Medicare nor Evercare® Medicare Advantage plans will be responsible for the costs. For HMOPOS members, with the exception of emergency or urgent care or out-of-area renal dialysis, it may cost more to get care from out-of-network providers. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486- 2048, 24 hours a day, 7 days a week; the Social Security Office at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday, TTY: 1-800-325-0778; or your state Medicaid office. By enrolling in an MA-PD you will automatically be disenrolled from any existing Medicare Prescription Drug coverage. To receive the highest level of benefit you must use contracted network pharmacies to access your prescription drug benefit except in the case of emergency. The pharmacy network includes retail, mail order, long-term care, home infusion and I/T/U (Indian Health Service, Tribes or Urban Indian) pharmacy services. You may obtain your prescriptions from pharmacies outside the contracted network at a reduced benefit. Quantity limitations and restrictions may apply. For information about mail order, names and addresses of network pharmacies or for more information call 1-877-702-5110, or TTY 711, Monday through Friday, 8:00 a.m. to 8:00 p.m. local time. Or write us at UnitedHealth Group, PSMG Privacy Office, MN006-W800, P.O. Box 1459, Minneapolis, MN 55440 or go to uhccommunityplan.com. The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed.