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inurance organization provider

UnitedHealthcare

Plan ID: H0609-62-0

UHC Complete Care TX-003P (HMO-POS C-SNP)

2024 UHC Complete Care TX-003P (HMO-POS C-SNP) H0609 — 062— 0 is a Medicare Advantage plan with drug coverage. It has received a 4.5-out-of-5 star rating from CMS for 2024.

Learn more about UHC Complete Care TX-003P (HMO-POS C-SNP) H0609 - 062 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.

4.5 / 5 stars for 2024

$0 /mo

Monthly premium

$0

Health deductible

$0

Drug deductible

$0

Out-of-pocket maximum

Enroll online

Call to enroll

OR

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Get personalized help from a licensed insurance agent
1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week!

OverviewBenefits & CostsDrug CoverageAdditional Benefits
Overview Icon

Plan Overview

2024 UHC Complete Care TX-003P (HMO-POS C-SNP) H0609 — 062— 0 is a HMOPOS offered in Select Counties in Texas by UnitedHealthcare. It has a monthly premium of $0.00.

Important:

2024 UHC Complete Care TX-003P (HMO-POS C-SNP) H0609 — 062 — 0 is a Chronic or Disabling Condition Special Needs Type plan. You can only enroll in this plan if you meet specific criteria.

Premium Breakdown

Standard Part B Premium

$174.80

Part B premium reduction

$0

Part C Premium

$0

Part D Basic Premium

$0

Part D Supplemental Premium

$0

Part D Total

$0.00

Monthly Premium (Parts C & D)

$0.00

Total Premium (Parts B, C, & D)

$164.90

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Special needs plan type

Yes

Out-of-pocket maximum

$0

Conditions Covered

Cardiovascular Disorders, Chronic Heart Failure, Diabetes

Plan Organization:

UnitedHealthcare

Plan Type:

HMOPOS

Location:

Select Counties in Texas

Drugs Covered:

Yes

Drug Formulary:

Formulary Link

Pharmacies:

Pharmacies Link

Doctor Choice:

Plan Doctors Only (some exceptions)

Doctors Link:

Doctors Link

Deductibles

The amount you must pay each year before your plan starts to pay for covered services or drugs.

Health deductible

$0

Drug deductible

$0

Sign up for UHC Complete Care TX-003P (HMO-POS C-SNP)

Enroll online

Call to enroll

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week

Drug Coverage Icon

Drug Coverage

UHC Complete Care TX-003P (HMO-POS C-SNP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Benefit Type

Enhanced Alternative

Prescription drug deductible

$0

Increased initial coverage limit

No

Additional gap coverage

Yes

Part D Premium Reduction

This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.

Part D

LIS 25%

LIS 50%

LIS 75%

LIS Full

$0.00

$0.00

$0.00

$0.00

$0.00

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.

30 Days
60 Days
90 Days

Tier

Preferred Pharmacy

Standard Pharmacy

Preferred Mail

Standard Mail

1. Preferred Generic

-

$0.00 copay

-

-

2. Standard Generic

-

$0.00 copay

-

-

3. Preferred Brand

-

$47.00 copay

-

-

4. Non-Preferred Drug

-

$100.00 copay

-

-

5. Specialty Tier

-

33%

33%

33%

Gap Coverage Phase

After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.

30 Days
60 Days
90 Days

Tier

Preffered Pharmacy

Standard Pharmacy

Preffered Mail

Standard Mail

Preferred Generic

-

$0.00 copay

-

-

Generic

-

$0.00 copay

-

-

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

Generic Drugs

$4.15 copay or 5% (whichever costs more)

Brand-name

$10.35 copay or 5% (whichever costs more)

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Additional Benefits

UHC Complete Care TX-003P (HMO-POS C-SNP) also provides the following benefits.

Additional Coverage Icon

Comprehensive dental

Non-routine services
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
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Diagnostic services
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Restorative services
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Endodontics
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Periodontics
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Extractions
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Prosthodontics, other oral/maxillofacial surgery, other services
In-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Out-Of-Network: 0-50% coinsurance
Limit IconExclamation IconReferral Icon
Additional Coverage Icon

Preventive dental

Oral exam
In-Network: $0 copay
Limit Icon
Out-Of-Network: $0 copay
Limit Icon
Cleaning
In-Network: $0 copay
Limit Icon
Out-Of-Network: $0 copay
Limit Icon
Fluoride treatment
In-Network: $0 copay
Limit Icon
Out-Of-Network: $0 copay
Limit Icon
Dental x-ray(s)
In-Network: $0 copay
Limit Icon
Out-Of-Network: $0 copay
Limit Icon
Additional Coverage Icon

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures
In-Network: $50 copay
Exclamation IconReferral Icon
Lab services
In-Network: $0 copay
Exclamation IconReferral Icon
Diagnostic radiology services (eg, MRI)
In-Network: $0-180 copay
Exclamation IconReferral Icon
Outpatient x-rays
In-Network: $0 copay
Exclamation IconReferral Icon
Additional Coverage Icon

Doctor visits

Primary
In-Network: $0 copay
Specialist
In-Network: $0-20 copay per visit
Exclamation IconReferral Icon
Additional Coverage Icon

Emergency care/Urgent care

Emergency
$135 copay per visit (always covered)
Urgent care
$0-40 copay per visit (always covered)
Additional Coverage Icon

Foot care (podiatry services)

Foot exams and treatment
In-Network: $20 copay
Exclamation IconReferral Icon
Routine foot care
In-Network: $20 copay
Limit IconExclamation IconReferral Icon
Additional Coverage Icon

Ground ambulance

Service
In-Network: $275 copay
Additional Coverage Icon

Hearing

Hearing exam
In-Network: $0 copay
Exclamation IconReferral Icon
Fitting/evaluation
Not covered
Limit Icon
Hearing aids
In-Network: $99-1,249 copay
Limit IconExclamation Icon
Additional Coverage Icon

Inpatient hospital coverage

Service
In-Network: $175 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond
Exclamation IconReferral Icon
Out-Of-Network: Not Applicable
Exclamation IconReferral Icon
Additional Coverage Icon

Outpatient hospital coverage

Service
In-Network: $0-175 copay per visit
Exclamation IconReferral Icon
Additional Coverage Icon

Outpatient prescription drugs

UHC Complete Care TX-003P (HMO-POS C-SNP) does not provide this type of benefit.

Additional Coverage Icon

Optional benefits

UHC Complete Care TX-003P (HMO-POS C-SNP) does not provide this type of benefit.

Additional Coverage Icon

Medical equipment/supplies

Durable medical equipment (eg, wheelchairs, oxygen)
In-Network: 20% coinsurance per item
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Prosthetics (eg, braces, artificial limbs)
In-Network: 20% coinsurance per item
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Diabetes supplies
In-Network: $0 copay
Exclamation Icon
Additional Coverage Icon

Medicare Part B drugs

Chemotherapy
In-Network: 0-20% coinsurance
Exclamation Icon
Other Part B drugs
In-Network: 0-20% coinsurance
Exclamation Icon
Part B Insulin drugs
In-Network: 0-20% coinsurance (up to $35)
Exclamation Icon
Additional Coverage Icon

Mental health services

Inpatient hospital - psychiatric
In-Network: $175 per day for days 1 through 5 $0 per day for days 6 through 90
Exclamation IconReferral Icon
Out-Of-Network: Not Applicable
Exclamation IconReferral Icon
Outpatient group therapy visit with a psychiatrist
In-Network: $15 copay
Exclamation IconReferral Icon
Outpatient individual therapy visit with a psychiatrist
In-Network: $0-25 copay
Exclamation IconReferral Icon
Outpatient group therapy visit
In-Network: $15 copay
Exclamation IconReferral Icon
Outpatient individual therapy visit
In-Network: $0-25 copay
Exclamation IconReferral Icon
Additional Coverage Icon

Preventive care

Service
In-Network: $0 copay
Additional Coverage Icon

Rehabilitation services

Occupational therapy visit
In-Network: $0-20 copay
Exclamation IconReferral Icon
Physical therapy and speech and language therapy visit
In-Network: $0-20 copay
Exclamation IconReferral Icon
Additional Coverage Icon

Skilled Nursing Facility

Service
In-Network: $0 per day for days 1 through 20 $203 per day for days 21 through 100
Exclamation IconReferral Icon
Out-Of-Network: Not Applicable
Exclamation IconReferral Icon
Additional Coverage Icon

Transportation

Service
Not covered
Additional Coverage Icon

Vision

Routine eye exam
In-Network: $0 copay
Limit IconExclamation IconReferral Icon
Other
Not covered
Limit Icon
Contact lenses
In-Network: $0 copay
Limit IconReferral Icon
Eyeglasses (frames and lenses)
In-Network: $0 copay
Limit IconReferral Icon
Eyeglass frames
Not covered
Limit Icon
Eyeglass lenses
Not covered
Limit Icon
Upgrades
Not covered
Additional Coverage Icon

Wellness programs (eg, fitness, nursing hotline)

Service
Covered
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1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week

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