2019 UnitedHealthcare Dual Complete® ONE (HMO SNP)

2020 UnitedHealthcare Dual Complete® ONE (HMO D-SNP) H0321-004-000

Dual Special Needs Program (DSNP)

H0321-004

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. 

This plan is designed for those enrolled in a long-term care Medicaid plan. It gives you a choice of doctors and hospitals. Plus you get coverage for a long list of prescription drugs. 

Benefits & Features

Dental Coverage

$3,750 toward dental services.

Protect your teeth and your gums by receiving regular dental care at no extra cost to you.

Dental coverage includes:

  • $3,750 toward your dental services.
  • Regular exams and cleanings every 6 months.
  • Restorative services like fillings, crowns, periodontal services, extractions, dentures, root canals and more.

Every 3 months you'll receive $275 in credits to order health products through the FirstLine catalog. The mail order products will be delivered directly to you at no extra cost.

Catalog products may include:

  • Oral care, eye and ear care items.
  • Pain relievers, cold remedies and vitamins.
  • Thermometers, blood pressure monitors and more.

Renew Active™ is a fitness program for mind and body designed for you and your goals – available exclusively to members at no extra cost.

Fitness benefit may include:

  • Standard membership access to an extensive group of participating locations, including local and national options.
  • An in-person fitness orientation to help get you started reaching your fitness-related goals.
  • Online brain exercises designed to help keep your mind active.

Help protect your eyesight and health with routine eye exams at no extra cost to you.

Vision coverage includes:

  • One routine eye exam every year.
  • $0 copay for standard eyeglass lenses.
  • $225 credit toward glasses or contacts every 2 years.

Up to 24 one-way rides every year.

24-hr. NurseLine

Speak with a registered nurse anytime at no extra cost.

Acupuncture and Chiropractic Coverage

$0 copay for up to 10 visits per year for pain relief due to things that affect muscles, nerves and bones.

Additional Benefits

More benefits than Original Medicare.

Foot Care Coverage

$0 copay for up to 4 visits per year to help keep your feet healthy.

Hearing Coverage

Annual exam and $2,500 every 2 years for hearing devices.

House Calls

Get a home visit from a health care practitioner at no extra cost.

Meal Program

Up to 14 meals in 7 days delivered to you with $0 copay.

No Referral Needed

Your choice of specialists within the network.

Personal Emergency Response System

Get connected to a trained operator quickly in any emergency situation 24 hours a day at no extra cost.

Prescription Drugs

Thousands of drugs available.

UnitedHealthcare Dual Complete® (HMO SNP)

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

Your level of extra help Monthly Premium*
100% $0.00
75% $6.20
50% $12.50
25% $18.70

*This does not include any Medicare Part B premium you may have to pay.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare of TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

Your health care needs are unique. These documents can help you make sure you get the right coverage.

Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary of Benefits, Other downloadable resources.

Downloadable Resources

Member Resources

View Available Resources