2020 UnitedHealthcare Dual Complete® (HMO D-SNP) H7464-001-000

2019 UnitedHealthcare Dual Complete® (HMO SNP) H7464-001

Dual Special Needs Program (DSNP)

H7464-001-000

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.

Alexandria City, Alleghany, Amelia, Amherst, Appomattox, Arlington, Augusta, Bath, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Caroline, Carroll, Charles City, Charlotte, Chesapeake City, Chesterfield, Clarke, Colonial Heights City, Covington City, Craig, Cumberland, Danville City, Dickenson, Dinwiddie, Emporia City, Essex, Fairfax, Fairfax City, Falls Church City, Fauquier, Floyd, Fluvanna, Franklin, Franklin City, Frederick, Fredericksburg City, Galax City, Giles, Gloucester, Goochland, Grayson, Greene, Greensville, Halifax, Hampton City, Hanover, Harrisonburg City, Henrico, Henry, Highland, Hopewell City, Isle of Wight, James City, King And Queen, King George, King William, Lancaster, Lee, Lexington City, Loudoun, Louisa, Lunenburg, Madison, Manassas City, Manassas Park City, Martinsville City, Mathews, Mecklenburg, Middlesex, Montgomery, Nelson, New Kent, Newport News City, Norfolk City, Northampton, Northumberland, Norton City, Nottoway, Orange, Page, Patrick, Petersburg City, Pittsylvania, Poquoson City, Portsmouth City, Powhatan, Prince George, Prince William, Pulaski, Radford City, Rappahannock, Richmond, Richmond City, Roanoke, Roanoke City, Rockbridge, Rockingham, Russell, Salem City, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Stafford, Staunton City, Suffolk City, Surry, Sussex, Tazewell, Virginia Beach City, Warren, Washington, Waynesboro City, Westmoreland, Williamsburg City, Winchester City, Wise, Wythe, and York.

Benefits & Features

OTC Network Card

Up to $1,000 in credits annually.

Every 3 months you'll receive $250 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.

Every 3 months you'll receive $250 in credits to order health products through the FirstLine Medical® catalog. The 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.

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.

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

Annual routine exam and $225 credit every 3 years for routine eyewear.

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 Activity Tracker

One Fitbit® activity tracker every two years at no extra cost.

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 28 meals in 14 days delivered once per year 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 an emergency situation 24 hours a day for $0.

Prescription Drug Coverage

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

Routine Hearing Coverage

Annual routine exam and $2500 credit every 2 years for hearing aids.

Solutions for Caregivers

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

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% $4.90
50% $9.80
25% $14.70

*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 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

Get Your Free Dual Plan Guide

Questions

Ask us anything.

Call to learn more about UnitedHealthcare Dual Complete® (HMO D-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

1-844-368-7151
TTY: 711


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