2020 UnitedHealthcare Dual Complete® (HMO D-SNP) H4590-033-000

Every 3 months you'll receive $300 loaded onto your card. You can use the card to buy health products at your local Walgreens or through the FirstLine Medical® catalog by mail, website or call center.

Covered products may include:

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

Dental Coverage

$2500 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 and nitrous oxide.

Transportation Assistance

Up to 60 one-way rides every year.

We can help you get to plan-approved locations so you can take care of your health needs. 60 one-way or 30 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.

Personal Emergency Response System

$0 copay for personal monitoring.

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.

Routine Hearing Coverage

Annual routine exam and $2000 credit every 2 years for hearing aids.

See More Benefits and Features

24-hr. NurseLine

Speak with a registered nurse anytime for $0.

Acupuncture and Chiropractic Coverage

$0 copay for up to 10 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 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 Vision Coverage

Annual routine exam and $200 credit every 2 years for routine eyewear.

Solutions for Caregivers

Speak to an experienced care manager who can provide resources to help meet your caregiving needs for $0.

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.

Costs

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%	$1.30
50%	$2.50
25%	$3.80

*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