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2021 UnitedHealthcare Dual Complete® ONE (HMO D-SNP)
Dual Special Needs Plan (DSNP)
H7464-005-000
Monthly Premium: $0.00*
* Your costs may be as low as $0, depending on your level of Medicaid eligibility.
This Health Maintenance Organization (HMO) plan gives you more benefits than Original Medicare, all for a $0 plan premium. You’ll keep all your Medicaid benefits, and add even more.
Accomack, Albemarle, Alexandria City, Alleghany, Amelia, Amherst, Appomattox, Arlington, Augusta, Bath, Bedford, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Campbell, Caroline, Carroll, Charles City, Charlotte, Charlottesville City, 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, Lynchburg City, 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 Edward, 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.
State Press Releases
Announcements from the Commonwealth about the Coronavirus (COVID-19) can be found below:
Governor Northam Outlines Plans for Novel Coronavirus (COVID-19) - March 4, 2020
Benefits & Features
Acupuncture
$0 copay for up to 12 routine acupuncture visits per year for relief of nausea or nerve, muscle, or joint pain
Chiropractic
$0 copay for up to 12 routine chiropractic visits per year for relief of nausea or nerve, muscle, or joint pain
Fitness program
Renew Active™ is a fitness program for body and mind to help stay active, at a gym or from home, at no additional cost
Fitness Benefit - Fitbit
Free Fitbit® activity tracker to help reach health and fitness goals by tracking activity, exercise, and more
Food Allowance
Up to $660 yearly on a debit card to buy fruits, vegetables, dairy products, meats, breads and more at many retailers
Foot Care - Routine
Up to 4 foot care visits per year with $0 copay to help keep feet healthy with routine exams and preventive care
Hearing
Routine hearing exam and $3600 allowance toward name-brand hearing aids or UnitedHealthcare Hearing's exclusive brand Relate™
HouseCalls
Yearly check-ups at home to help stay up-to-date on your health between regular doctor's visits at no extra cost
Meal Benefit
$0 copay for up to 28 meals for 14 days, delivered 1 time per year after a hospital stay to maintain nutrition
Nursing Hotline
Speak to a registered nurse about your health-related questions or concerns anytime, day or night at no extra cost
OTC Items - Debit
Up to $2,000 yearly on a debit card to buy over-the-counter products at many retailers or for home delivery
Personal emergency response system
Personal emergency response device that can get you help quickly, 24 hours a day at no extra cost
Referral
Access to our large provider network with no specialty referrals required
Telehealth Medical & Mental
$0 copay virtual provider visits to discuss non-emergency medical concerns or general mental health conditions from home
Telehealth Mental
$0 copay virtual mental health visits to get a private evaluation and treatment for general mental health conditions
Transportation
$0 copay for unlimited rides to or from non-emergency medical doctor visits or to get prescription medications
Worldwide ER
Coverage for emergency and urgent care needs worldwide with $0 copay
Extra Help With Costs: LIS Premium Summary Table
UnitedHealthcare Dual Complete® ONE (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% | $7.90 |
| 50% | $15.70 |
| 25% | $23.60 |
*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.
Learn More
UnitedHealthcare Dual Complete® ONE (HMO D-SNP)
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