2020 UnitedHealthcare Dual Complete® (HMO D-SNP)

2019 UnitedHealthcare Dual Complete® (HMO SNP) H3387-010

Dual Special Needs Program (DSNP)

H3387-010-000

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 doctors and hospitals. Plus you get coverage for a long list of prescription drugs.

Albany, Allegany, Bronx, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Erie, Essex, Genesee, Greene, Hamilton, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Montgomery, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, Steuben, Suffolk, Sullivan, Tioga, Ulster, Warren, Washington, Wayne, Westchester, Wyoming, and Yates.

Benefits & Features

OTC Network Card

Up to $1,200 in credits annually.

Every 3 months you'll receive $100 in credits loaded onto your card. You can use the card to buy health-related items at participating retailers near you.

Covered products may include:

  • Oral care, eye and ear care items.
  • Pain relievers, cold remedies and vitamins.
  • Thermometers, blood pressure monitors and more.

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 year.

Don't let hearing loss affect your life. Take advantage of the routine hearing exam and hearing aids benefit.

Routine Hearing coverage includes:

  • One routine hearing exam every year.
  • $1100 credit toward hearing aids every 2 years.
  • Support and assistance to help you hear better.

$0 copay for up to 20 visits per year for pain relief due to things that affect muscles, nerves and bones.

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 42 meals in 14 days delivered once per year with $0 copay.

No Referral Needed

Your choice of specialists within the network.

Personal Care Specialist

Personalized, local help available via phone.

Personal Emergency Response System

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

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® (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% $7.40
50% $14.80
25% $22.20

*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