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UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
You have selected UnitedHealthcare Dual Complete™ (HMO SNP).
The plan you are looking for is no longer available. This is the current year equivalent.

UnitedHealthcare Dual Complete™ (HMO SNP)

This plan gives you a choice doctors and hospitals. Plus you get coverage for a long list of prescription drugs.

Call us to learn more:
1-866-864-2079 / TTY: 711

Call us to learn more:
1-866-864-2079
TTY: 711

8 a.m. – 8 p.m. local time,
7 days a week

8 a.m. – 8 p.m. local time,
7 days a week

Have Questions? Call Us at:
1-866-864-2079 / TTY: 711

Have Questions? Call Us at:
1-866-864-2079
TTY: 711

8 a.m. – 8 p.m. local time,
7 days a week

8 a.m. – 8 p.m. local time,
7 days a week

See if your doctor or hospital is in our network. Or use this tool to find a new doctor, hospital or specialist.

This plan is available in the following counties:

Bee, Jim Wells, Kleberg, Nueces and San Patricio.

View Eligibility

Dental Work

Dental Work

$2,000 toward dental services.

We cover up to a total of $2,000 per year for dental checkups and other dental procedures.  There is no additional cost to you.

Our dental coverage includes:

  • Restorative services like crowns.
  • Tooth extractions and more.
Health Products Catalog

Health Products Catalog

Up to $520 in credits to buy things you may need.

Get up to $130 every 3 months to buy products you may need. We'll deliver them directly to you, with no cost for shipping and handling or taxes.

Our catalog offers products like:

  • Dental care products.
  • Bandages and skin care products.
  • Cough medicine and vitamins.
  • Thermometers, blood pressure monitors and more.
Transportation Assistance

Transportation Assistance

Up to 24 one-way rides every year.

No matter where you live, our plan provides up to 12 round-trip rides to and from plan-sponsored locations. There is no additional cost to you.

With our plan, you'll have transportation to:

  • Your doctor's office.
  • Your pharmacy.
  • Other approved medical sites.
Emergency Care

Emergency Care

Travel freely with worldwide emergency care.

You may go to any emergency room if you reasonably believe you need emergency care. And that’s true anywhere in the world. No matter where you go, you’ll have peace of mind with worldwide coverage.

Additional Eyewear

Additional Eyewear

Credit for contacts or lenses and frames.

Get the eyewear you need to see clearly and look great. Coverage includes:

  • $200 credit for contact lenses or frames and one pair of lenses every 2  years.
Dental Exams

Dental Exams

$0 copay for routine exams.

We cover routine dental exams every 6 months to help protect your teeth and gums. There is no additional cost to you. 

Our dental coverage includes:

  • Checkups every 6 months.
  • Cleanings every 6 months.
  • Routine complete x-rays twice every year.
Provider Network

Provider Network

Choice of doctors and hospitals.

From regular checkups to preventive health screenings, we want to make sure you get the right care at the right time.

You get a primary care physician (PCP) who is your main doctor. If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.
Hearing Aids

Hearing Aids

$2,000 credit every 2 years.

If you’d benefit from a hearing aid, we’ll help you get one. At no additional cost.

NurseLine<sup>SM</sup>

NurseLineSM

Speak with a registered nurse anytime.

Everyone has questions about their health. With NurseLine, you can call 24 hours a day, 7 days a week and get answers about your health. There is no additional cost to you. 

A registered nurse can answer questions like:

  • Should I go to the emergency room or see a doctor?
  • How do I find a doctor or a hospital?
  • How does this medication work? Can I save money on it?
Dental Work

Dental Work

$2,000 toward dental services.

We cover up to a total of $2,000 per year for dental checkups and other dental procedures.  There is no additional cost to you.

Our dental coverage includes:

  • Restorative services like crowns.
  • Tooth extractions and more.
Health Products Catalog

Health Products Catalog

Up to $520 in credits to buy things you may need.

Get up to $130 every 3 months to buy products you may need. We'll deliver them directly to you, with no cost for shipping and handling or taxes.

Our catalog offers products like:

  • Dental care products.
  • Bandages and skin care products.
  • Cough medicine and vitamins.
  • Thermometers, blood pressure monitors and more.
Transportation Assistance

Transportation Assistance

Up to 24 one-way rides every year.

No matter where you live, our plan provides up to 12 round-trip rides to and from plan-sponsored locations. There is no additional cost to you.

With our plan, you'll have transportation to:

  • Your doctor's office.
  • Your pharmacy.
  • Other approved medical sites.
Emergency Care

Emergency Care

Travel freely with worldwide emergency care.

You may go to any emergency room if you reasonably believe you need emergency care. And that’s true anywhere in the world. No matter where you go, you’ll have peace of mind with worldwide coverage.

Additional Eyewear

Additional Eyewear

Credit for contacts or lenses and frames.

Get the eyewear you need to see clearly and look great. Coverage includes:

  • $200 credit for contact lenses or frames and one pair of lenses every 2  years.
Dental Exams

Dental Exams

$0 copay for routine exams.

We cover routine dental exams every 6 months to help protect your teeth and gums. There is no additional cost to you. 

Our dental coverage includes:

  • Checkups every 6 months.
  • Cleanings every 6 months.
  • Routine complete x-rays twice every year.
Provider Network

Provider Network

Choice of doctors and hospitals.

From regular checkups to preventive health screenings, we want to make sure you get the right care at the right time.

You get a primary care physician (PCP) who is your main doctor. If you don’t have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.
Hearing Aids

Hearing Aids

$2,000 credit every 2 years.

If you’d benefit from a hearing aid, we’ll help you get one. At no additional cost.

NurseLine<sup>SM</sup>

NurseLineSM

Speak with a registered nurse anytime.

Everyone has questions about their health. With NurseLine, you can call 24 hours a day, 7 days a week and get answers about your health. There is no additional cost to you. 

A registered nurse can answer questions like:

  • Should I go to the emergency room or see a doctor?
  • How do I find a doctor or a hospital?
  • How does this medication work? Can I save money on it?

Monthly Premium1*

$0.00

1Amount shown does not include Medicare Part B premium, which you must continue to pay if not otherwise paid for under Medicaid or by another third party. Beneficiaries who qualify for extra help may pay a lower monthly plan premium. For more information, see Paying for Medicare.

*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Drug Copays or Coinsurance*

25% for Tier 1
25% for Tier 2
25% for Tier 3
25% for Tier 4
25% for Tier 5
*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Medical Copays, Coinsurance or Deductible*

Office Visits2
$0.00 for primary care physicians
20% for specialists

Inpatient Hospital Visits3
$1188.00 per stay

 

2Numbers shown in this table reflect in-network copayments. Depending on the type of plan you choose, if you obtain care from out-of-network providers, those services may not be covered by the plan or you may have to pay higher copayments/coinsurance than shown here. See a plan's Evidence of Coverage for specific copayments or coinsurance.

3Amounts may vary depending on the level of care provided or the type of health care services you receive.

*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Out-of-Pocket Maximum*

In-network
$6700
*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Help With Costs

UnitedHealthcare Dual Complete™ (HMO SNP) premium includes coverage for both medical services and prescription drug coverage. 

If you receive help from Medicare to pay your prescription drug costs, you probably qualify for help reducing your monthly premium.

This help doesn't pay for everything – you must still pay your Medicare Part B premium (if it's not paid for by Medicaid or another group).

Who to Call

If you have any questions, please call Customer Service at 1-866-864-2079 / TTY: 711 from 8 a.m. – 8 p.m. local time, 7 days a week. 

If you don't get any extra help now, check to see if you qualify by calling:

  • Medicare at 1-800-Medicare (TTY/TDD users can call 1-877-486-2048) 24 hours a day, 7 days a week
  • Your State Medicaid Office
  • Social Security at 1-800-772-1213 (TTY/TDD users can call 1-800-325-0778) between 7:00 AM and 7:00 PM, Monday through Friday
Level Of Extra Help 100% 75% 50% 25%
Adjusted Premium $0.00 $4.80 $9.60 $14.50

State Pharmaceutical Assistance Program

State Pharmaceutical Assistance Programs (SPAP) help low-income residents pay for prescription drug costs. To learn how to contact your state SPAP, call 1-866-255-4835, 24 hours a day, 7 days a week. TTY users, call 1-877-730-4192. Or, visit the Web site of the State Pharmaceutical Assistance Program.

Best Available Evidence policy

Learn about the Best Available Evidence policy from CMS and how it pertains to you.

Pharmaceutical Assistance Programs for Texas

A State Pharmaceutical Assistance Program (SPAP) provides state-funded prescription drug assistance to people who need help paying for their monthly prescription drug plan premiums and/or copays.

For most programs, members must meet specific income guidelines and additional requirements that vary by state.

All Evercare prescription drug plans for Texas coordinate assistance with this program:

Kidney Health Care

You may be eligible for financial assistance through your state. To learn how to contact your state SPAP, call 1-866-255-4835, 24 hours a day, 7 days a week. TTY users, call 1-877-730-4192. Or, visit the Web site of the State Pharmaceutical Assistance Program.

Monthly Premium1*

$0.00

1Amount shown does not include Medicare Part B premium, which you must continue to pay if not otherwise paid for under Medicaid or by another third party. Beneficiaries who qualify for extra help may pay a lower monthly plan premium. For more information, see Paying for Medicare.

*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Drug Copays or Coinsurance*

25% for Tier 1
25% for Tier 2
25% for Tier 3
25% for Tier 4
25% for Tier 5
*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Medical Copays, Coinsurance or Deductible*

Office Visits2
$0.00 for primary care physicians
20% for specialists

Inpatient Hospital Visits3
$1188.00 per stay

 

2Numbers shown in this table reflect in-network copayments. Depending on the type of plan you choose, if you obtain care from out-of-network providers, those services may not be covered by the plan or you may have to pay higher copayments/coinsurance than shown here. See a plan's Evidence of Coverage for specific copayments or coinsurance.

3Amounts may vary depending on the level of care provided or the type of health care services you receive.

*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Out-of-Pocket Maximum*

In-network
$6700
*Your costs may be as low as $0, depending on your level of Medicaid eligibility. Please call 1-866-864-2079 TTY: 711 8 a.m. – 8 p.m. local time, 7 days a week for more information on your costs with this plan.

Help With Costs

UnitedHealthcare Dual Complete™ (HMO SNP) premium includes coverage for both medical services and prescription drug coverage. 

If you receive help from Medicare to pay your prescription drug costs, you probably qualify for help reducing your monthly premium.

This help doesn't pay for everything – you must still pay your Medicare Part B premium (if it's not paid for by Medicaid or another group).

Who to Call

If you have any questions, please call Customer Service at 1-866-864-2079 / TTY: 711 from 8 a.m. – 8 p.m. local time, 7 days a week. 

If you don't get any extra help now, check to see if you qualify by calling:

  • Medicare at 1-800-Medicare (TTY/TDD users can call 1-877-486-2048) 24 hours a day, 7 days a week
  • Your State Medicaid Office
  • Social Security at 1-800-772-1213 (TTY/TDD users can call 1-800-325-0778) between 7:00 AM and 7:00 PM, Monday through Friday
Level Of Extra Help 100% 75% 50% 25%
Adjusted Premium $0.00 $4.80 $9.60 $14.50

State Pharmaceutical Assistance Program

State Pharmaceutical Assistance Programs (SPAP) help low-income residents pay for prescription drug costs. To learn how to contact your state SPAP, call 1-866-255-4835, 24 hours a day, 7 days a week. TTY users, call 1-877-730-4192. Or, visit the Web site of the State Pharmaceutical Assistance Program.

Best Available Evidence policy

Learn about the Best Available Evidence policy from CMS and how it pertains to you.

Pharmaceutical Assistance Programs for Texas

A State Pharmaceutical Assistance Program (SPAP) provides state-funded prescription drug assistance to people who need help paying for their monthly prescription drug plan premiums and/or copays.

For most programs, members must meet specific income guidelines and additional requirements that vary by state.

All Evercare prescription drug plans for Texas coordinate assistance with this program:

Kidney Health Care

You may be eligible for financial assistance through your state. To learn how to contact your state SPAP, call 1-866-255-4835, 24 hours a day, 7 days a week. TTY users, call 1-877-730-4192. Or, visit the Web site of the State Pharmaceutical Assistance Program.

Downloadable Resources

UnitedHealthcare Dual Complete™ (HMO SNP)

Medicare Plan Rating
Summary of Benefits
Evidence of Coverage
Health Products Benefit
Annual Notice of Changes

Questions?

Ready to Enroll?

Call Us
1-866-864-2079
TTY: 711

8 a.m. – 8 p.m. local time,
7 days a week

Enrollment Tools

Member Information

Summary of Benefits

More Resources

Member Page

View more news, updates and resources for members.

Lookup Tools

Doctor Lookup

Search for doctors, hospitals, and specialists.

Download Directories
Dentist Lookup

Find a dentist near you.

Pharmacy Search

Find a pharmacy near you.

View Drug List

Find medications covered by this plan.

Download Formularies

Enrollment Tools

Member Information

More Resources

View more news, updates and resources for members.