2021 UnitedHealthcare Dual Complete® ONE (HMO D-SNP)

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

Dual Special Needs Plan (DSNP)

H0321-004-000

Monthly Premium: $0.00*

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

This Health Maintenance Organization (HMO) plan gives you more benefits than Original Medicare, all for a $0 plan premium. You’ll keep all your Medicaid benefits, and add even more.

Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pinal, and Yavapai.

Arizonans can apply to receive five cloths masks through the mail, click here.

Arizona has launched Project Catapult to enhance state partnerships to increase testing facilities around the state. Find a testing facility near you by clicking here.

Information about COVID-19 is available from the Centers for Disease Control (CDC) and the Arizona Department of Health Services. The Arizona Poison Control System is now available to take COVID-19 calls from Arizona providers and the general public at 1-844-542-8201.

AHCCCS COVID-19 Information: https://azahcccs.gov/AHCCCS/AboutUs/covid19.html

AHCCCS FAQ Regarding COVID-19: https://azahcccs.gov/AHCCCS/AboutUs/covid19FAQ.html

Announcements from the Arizona Department of Health Services (ADHS) about the Coronavirus (COVID-19) can be found below:

Benefits & Features

Dental

Up to $4000 for covered dental services such as certain cleanings, fillings, crowns, root canals, extractions and dentures

Up to $1,160 yearly to buy over-the-counter products in-store or for home delivery, plus up to $600 yearly in healthy food at many retailers

$0 copay for 36 one-way rides to or from non-emergency medical doctor visits or to get prescription medications

$0 copay virtual provider visits to discuss non-emergency medical concerns or general mental health conditions from home

$0 copay for up to 12 routine acupuncture visits per year for relief of nausea or nerve, muscle, or joint pain

Adult Daycare

$0 copay for up to 9 days per month of center-based adult care and companionship during the day, giving caregivers peace of mind

Chiropractic

$0 copay for up to 12 routine chiropractic visits per year for relief of nausea or nerve, muscle, or joint pain

Fitness program

Renew Active™ is a fitness program for body and mind to help stay active, at a gym or from home, at no additional cost

Food Allowance

Up to $600 yearly on a debit card to buy fruits, vegetables, dairy products, meats, breads and more at many retailers

Foot Care - Routine

Up to 4 foot care visits per year with $0 copay to help keep feet healthy with routine exams and preventive care

Hearing

Routine hearing exam and $2500 allowance toward name-brand hearing aids or UnitedHealthcare Hearing's exclusive brand Relate™

HouseCalls

Yearly check-ups at home to help stay up-to-date on your health between regular doctor's visits at no extra cost

Meal Benefit

$0 copay for up to 42 meals for 21 days, delivered 1 time per year after a hospital stay to maintain nutrition

Nursing Hotline

Speak to a registered nurse about your health-related questions or concerns anytime, day or night at no extra cost

OTC Items - Debit

Up to $1,160 yearly on a debit card to buy over-the-counter products at many retailers or for home delivery

Personal emergency response system

Personal emergency response device that can get you help quickly, 24 hours a day at no extra cost

Prescription Drug Coverage

$0 drug copays on all tiers of covered generic and name-brand prescription medications with option for home delivery

Referral

Access to our large provider network with no specialty referrals required

Vision

Routine eye exam and $225 allowance for contacts or frames, with standard (single, bi-focal, tri-focal or standard progressive) lenses covered in full

Telehealth Medical

$0 copay virtual provider visits to discuss medical concerns, get a diagnosis and treatment for non-emergency conditions

Telehealth Mental

$0 copay virtual mental health visits to get a private evaluation and treatment for general mental health conditions

Worldwide ER

Coverage for emergency and urgent care needs worldwide with $0 copay

UnitedHealthcare Dual Complete® (HMO D-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% $9.00
50% $18.10
25% $27.10

*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