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UnitedHealthcare® Senior Care Options (HMO D-SNP)
Dual Special Needs Plan (DSNP)
H2226-001-000
Monthly Premium: $0.00*
* As a UnitedHealthcare Senior Care Options member, you have no out-of-pocket expenses. You will not be responsible for any copayments or coinsurance for drugs or other covered services provided by plan providers.
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.
Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester.
Benefits & Features
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 $300 yearly on a debit card to buy fruits, vegetables, dairy products, meats, breads and more at many retailers
Foot Care - Routine
Up to 6 foot care visits per year with $0 copay to help keep feet healthy with routine exams and preventive care
Hearing
$0 copay for routine hearing exam and coverage for hearing aids to help hear sounds you've been missing
HouseCalls
Yearly check-ups at home to help stay up-to-date on your health between regular doctor's visits at no extra cost
OTC Items - Debit
Up to $600 yearly on a debit card to buy over-the-counter products at many retailers or for home delivery
Referral
Access to our large provider network with no specialty referrals required
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
Extra Help With Costs: LIS Premium Summary Table
Monthly Premium
$0
Drugs Copays or Coinsurance
$0
Medical Copays, Coinsurance or Deductible
Office Visits
$0
Inpatient Hospital Visits
$0
Out-of-Pocket Maximum
In-network and Out-of-network
$0
Help With Costs
UnitedHealthcare® Senior Care Options (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% | $6.70 |
| 50% | $13.40 |
| 25% | $20.10 |
*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.
For more information on Medicaid-specific benefits or appeals and grievances information, click the link above to review the Evidence of Coverage.
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.
For more information on Medicaid-specific benefits or appeals and grievances information, click the link above to review the Evidence of Coverage.
Learn More
UnitedHealthcare® Senior Care Options (HMO D-SNP)
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