Disclaimer information
Advertising:
You must have Medicare Parts A and B, and must reside in the service area of the plan. 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, living in a contracted nursing home, or having a qualifying chronic care condition.
Evercare® Medicare Advantage Plans are offered by United Healthcare Insurance Company and its affiliated companies, Medicare Advantage organizations with a Medicare contract. Limitations, co-payments and coinsurance will apply.
Pre Enrollment:
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, living in a contracted nursing home, or having a qualifying chronic care condition. This document is available in alternative formats. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. You must have Medicare Parts A and B, and must reside in the service area of the plan. You must have State Medical Assistance to enroll in some plans. For PPO enrollees, reimbursement is provided for all covered benefits regardless of whether they are received in network. You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call-1-800-325-0778; or your State Medicaid Office. Medicare beneficiaries may enroll in Evercare plans through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov. For more information contact Evercare at 1-888-834-3721. TTY users can call 1-800-387- 1074. If you are already enrolled in a Medicare Advantage Prescription Drug Plan you must receive your Medicare Prescription Drug benefit through that plan. 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. You may obtain your prescriptions from pharmacies outside the contracted network at a reduced benefit. 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. Only Native Americans and Alaska Natives have access to the Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through Evercare's pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g. emergencies). For information about mail order, names and addresses of network pharmacies or for more information call 1-888-867-5518, or TTY 1-888-685-8480, Monday through Friday, 8:00 a.m. to 8:00 p.m. local time. Or write to us at: Evercare, PO Box 29600, Hot Springs, AR 71903-0600. The plan's contract with CMS is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed. [Benefits may vary by county [and plan].
Evercare® Medicare Advantage plans are offered by United HealthCare Insurance Company and its affiliated companies, Medicare Advantage Organizations with a Medicare contract.
Advertising/Pre-Enrollment Disclaimers
UHC Dual SNP Plans (have a contract with state Medicaid program)
UnitedHealthcare® Medicare Advantage plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program. This plan is available to anyone who has both Medical Assistance from the State and Medicare.
UHC Dual SNP Plans (without a contract with state Medicaid program)
UnitedHealthcare® Medicare Advantage plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Coordinated Care plan with a Medicare Advantage contract but without a contract with the state Medicaid program. This plan is available to anyone who has both Medical Assistance from the State and Medicare.
UnitedHealthcare Senior Care Options (HMO SNP) Plan
UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. UnitedHealthcare Senior Care Options (UnitedHealthcare SCO) is a voluntary program available to people who are 65 and older. UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program.
Post-Enrollment Disclaimers
UHC Dual SNP Plans (have a contract with state Medicaid program)
UnitedHealthcare® Medicare Advantage plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program.
UHC Dual SNP Plans (without a contract with state Medicaid program)
UnitedHealthcare® Medicare Advantage plans are insured through UnitedHealthcare Insurance Company and its affiliated companies, a Coordinated Care plan with a Medicare Advantage contract but without a contract with the state Medicaid program.
UnitedHealthcare Senior Care Options (HMO SNP) Plans
UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program.
Additional Disclaimers from the MMG
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply.
Additional Required Benefits Disclaimers:
[Materials for MA Only: Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year.]
[Materials for MAPD Only: Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.]
[Materials for PDP Only: Formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.
You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party.
The bold bracketed section below is for SCO DSNP ONLY
[premiums],[co-pays],[co-insurance], and [deductibles] may vary based on the level of Extra Help you receive. Please contact the plan for further details. [Enrollees have no out of pocket costs.]
A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings call.
This information is available for free in other languages. Please contact our customer service number at 1-800-905-8671, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.
[Esta información está disponible sin costo en otros idiomas. Comuníquese con nuestro Servicio al Cliente al número 1-800-905-8671, TTY 711, de 8 a.m. – 8 p.m. hora local, los 7 días de la semana>]
Privacy Statement for Sales Scripts and/or Talking Points
You are not required to provide any health related information unless it will be used to determine enrollment eligibility.
Star Ratings Disclaimer
Plan performance Star Ratings are assessed each year and may change from one year to the next.
Formularies on Plan Sponsor Websites
(For drugs with a Part B versus D administrative prior authorization requirement, the following disclaimer must be included):
This drug may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the drug to make the determination.
UnitedHealthcare Dual Complete™ covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
(In addition to the information above, a plan may also choose to include search results that list formulary alternatives for the drug entered in the online search tool. If not all formulary alternatives will be listed, the plan must include the following disclaimer):
This is not a complete list of all formulary alternatives covered by the Part D plan for the drug you have selected.
