2020 UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-005-000

2019 UnitedHealthcare Dual Complete® (PPO SNP) H0271-005

Dual Special Needs Program (DSNP)

H0271-005-000

Monthly Premium: $0.00*

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

Adams, Allen, Bartholomew, Benton, Blackford, Boone, Brown, Carroll, Cass, Clark, Clay, Clinton, Crawford, Daviess, DeKalb, Dearborn, Decatur, Delaware, Dubois, Elkhart, Fayette, Floyd, Fountain, Franklin, Fulton, Gibson, Grant, Greene, Hamilton, Hancock, Harrison, Hendricks, Henry, Howard, Huntington, Jackson, Jasper, Jay, Jefferson, Jennings, Johnson, Knox, Kosciusko, La Porte, Lagrange, Lake, Lawrence, Madison, Marion, Marshall, Martin, Miami, Monroe, Montgomery, Morgan, Newton, Noble, Ohio, Orange, Owen, Parke, Perry, Pike, Porter, Posey, Pulaski, Putnam, Randolph, Ripley, Rush, Scott, Shelby, Spencer, St. Joseph, Starke, Steuben, Sullivan, Switzerland, Tippecanoe, Tipton, Union, Vanderburgh, Vermillion, Vigo, Wabash, Warren, Warrick, Washington, Wells, White, and Whitley.

Benefits & Features

Dental Coverage

$3000 toward dental services.

Protect your teeth and gums by receiving regular dental care.

Dental coverage includes:

  • Routine cleanings and periodontal maintenance.
  • Routine exams, commonly used x-rays and fluoride treatments.
  • Comprehensive services including certain types of: fillings, crowns, bridges, periodontal services, extractions, root canals, dentures, sedation and occlusal guards.

Every 3 months you'll receive $200 in credits to order health products through the FirstLine Medical® catalog. The 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.

We can help you get to plan-approved locations so you can take care of your health needs. 48 one-way or 24 round trips are available at no extra cost to you.

Transportation coverage may include:

  • Rides to health providers like doctors and dentists.
  • Rides to your pharmacy.
  • Wheelchair accessible vehicles as needed.

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.
  • $300 credit toward glasses or contacts every 2 years.

Get connected to a trained operator quickly in an emergency situation 24 hours a day for $0.

24-hr. NurseLine

Speak with a registered nurse anytime for $0.

Additional Benefits

More benefits than Original Medicare.

Fitness Benefit

A fitness program for body and mind with access to participating gym and fitness centers for $0.

Foot Care Coverage

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

No Referral Needed

Your choice of specialists within the network.

Routine Hearing Coverage

Annual routine exam and $2000 credit every 2 years for hearing aids.

Prescription Drug Coverage

Access to thousands of prescription medications commonly chosen by doctors and pharmacies.

UnitedHealthcare® HouseCalls

Get a yearly in-home preventative care visit with a health care practitioner at no extra cost.

Virtual Medical Visits

Talk to a provider 24 hours a day, 7 days a week with $0 copay.

Worldwide Emergency Coverage

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

UnitedHealthcare Dual Complete® (PPO 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% $7.00
50% $14.00
25% $21.00

*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