2020 UnitedHealthcare Dual Complete® (HMO D-SNP) H5253-041-000

2019 UnitedHealthcare Dual Complete® (HMO SNP) H5253-041

Dual Special Needs Program (DSNP)

H5253-041-000

Monthly Premium: $0.00*

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

This plan gives you a choice of doctors and hospitals. Plus you get coverage for a long list of prescription drugs.

 

Statement of support for North Carolinians Affected by Hurricane Dorian  

UnitedHealthcare is taking action to help people who may be affected by Hurricane Dorian, which is expected to impact communities in North Carolina.  This includes providing support to our 50,000-plus DSNP members, with a majority of the population residing in the eastern part of the state.

UnitedHealthcare is taking the following actions to ensure DSNP members are provided with resources and access to care:

  • Free help line:  Optum, a leading health and behavioral health services company, is offering a free emotional-support help line. The toll-free number, 866-342-6892, will be open 24 hours a day, seven days a week, for as long as necessary. The service is free of charge and open to anyone. Specially trained Optum mental health specialists help people manage their stress and anxiety so they can continue to address their everyday needs. Callers may also receive referrals to community resources to help them with specific concerns, including financial and legal matters.
  • Online support: Along with the toll-free help line, emotional-support resources and information are available online at www.liveandworkwell.com
  • Customer care for help finding a network care provider, early refills:  Plan participants who need help finding a care provider in the UnitedHealthcare network or obtaining early prescription refills can call customer care at the number located on the back of their health plan ID cards. 
  • Members that do not have access to their ID card can call 866-633-2446, 8 a.m. – 8 p.m. ET (or local time) Monday through Friday. 

Alamance, Buncombe, Caswell, Catawba, Chatham, Cumberland, Davidson, Davie, Durham, Forsyth, Guilford, Henderson, Mecklenburg, Orange, Person, Randolph, Rockingham, Rowan, Stokes, Wake, Wilkes, and Yadkin.

Benefits & Features

Dental Coverage

$3500 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.

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.

Key features include:

  • Delivered right to your door with the option for personal or professional setup for $0.
  • Lightweight button can be worn on your wrist or as a pendant and may automatically detect falls.
  • Wireless or landline compatible and works in any U.S. home where cellular or telephone service exists.

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.

Up to $1,600 in credits to place catalog orders for health products you may need.

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.

Meal Program

Up to 14 meals in 7 days delivered once per year with $0 copay.

No Referral Needed

Your choice of specialists within the network.

Prescription Drug Coverage

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

Routine Hearing Coverage

Annual routine exam and $3600 credit every 2 years for hearing aids.

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.

Virtual Mental Health Visits

Get confidential care from a provider online and help keep your mental health in check with $0 copay.

Worldwide Emergency Coverage

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% $6.00
50% $12.10
25% $18.10

*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 Benefits, Other downloadable resources.

Downloadable Resources

Member Resources

View Available Resources