UnitedHealthcare® Senior Care Options NHC (HMO D-SNP)

Dual Special Needs Plan (DSNP)

H2226-003-000

Monthly Premium: $0.00*

* As a UnitedHealthcare® Senior Care Options NHC 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

Dental

$0 copay for covered dental services such as certain cleanings, crowns, root canals, extractions, dentures and implants

Up to $600 yearly to buy over-the-counter products in-store or for home delivery, plus up to $300 yearly in healthy food at many retailers

$0 copay for drug coverage on thousands of covered generic and name-brand prescription medications with home delivery option

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

Routine eye exam and $200 allowance for contacts or frames, with standard (single, bi-focal, tri-focal or standard progressive) lenses covered in full

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

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

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

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 NHC (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% $5.80
50% $11.50
25% $17.30

*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.

2020 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.

2021 Downloadable Resources

For more information on Medicaid-specific benefits or appeals and grievances information, click the link above to review the Evidence of Coverage.