2019 UnitedHealthcare Dual Complete® - PA (HMO SNP) H3113-009

2020 UnitedHealthcare Dual Complete® - PA (HMO D-SNP) H3113-009-000

Dual Special Needs Program (DSNP)

H3113-009

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. H3113-009

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

Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bucks, Butler, Cambria, Carbon, Chester, Clarion, Crawford, Cumberland, Dauphin, Erie, Fayette, Forest, Franklin, Greene, Huntingdon, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Mercer, Monroe, Northampton, Perry, Philadelphia, Snyder, Somerset, Susquehanna, Venango, Warren, Washington, Westmoreland, Wyoming, and York.

Benefits & Features

Dental Coverage

$2500 toward dental services.

Protect your teeth and your gums by receiving regular dental care at no extra cost to you.

Dental coverage includes:

  • $2500 toward your dental services.
  • Regular exams and cleanings every 6 months.
  • Restorative services like fillings, crowns, periodontal services, extractions, dentures, root canals and more.

Every 3 months you'll receive $190 in credits to order health products through the FirstLine catalog. The mail order 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.

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.

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.
  • $150 credit toward glasses or contacts every year.

Up to 48 one-way rides every year.

24-hr. NurseLine

Speak with a registered nurse anytime at no extra cost.

Additional Benefits

More benefits than Original Medicare.

Fitness Benefit

Unlimited access to thousands of participating fitness locations across the country at no extra cost.

Foot Care Coverage

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

Hearing Coverage

Annual exam and $1,000 credit every 2 years for hearing devices.

House Calls

Get a home visit from a health care practitioner at no extra cost.

Meal Program

Up to 14 meals in 7 days delivered to you with $0 copay.

No Referral Needed

Your choice of specialists within the network.

Personal Emergency Response System

Get connected to a trained operator quickly in any emergency situation 24 hours a day at no extra cost.

Prescription Drugs

Thousands of drugs available.

UnitedHealthcare Dual Complete® - PA (HMO 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% $6.50
50% $12.90
25% $19.40

*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
Check Eligibility

Enrollment

Enroll online today.

Please have your Medicaid and Medicare information ready.

Enroll in Plan

Enroll by Phone

8 a.m. – 8 p.m. local time,
7 days a week

1-844-812-5967
TTY: 711

Request a Call

Steps to Sign Up

Enroll by Mail

Application

Enrollment Kit

Get Your Free Dual Plan Guide

Questions

Ask us anything.

Call to learn more about UnitedHealthcare Dual Complete® - PA (HMO SNP).

8 a.m. – 8 p.m. local time,
7 days a week

1-844-812-5967
TTY: 711

Already a member?

Call any day, 8 a.m. – 8 p.m. local time, 7 days a week

1-800-290-4009

TTY: 711

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