H0271 046 - TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL):

 
UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... . Pnnfxpueiq

Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Home Medicare Medicare Plans UnitedHealthcare Dual Complete Choice (PPO D-SNP) UnitedHealthcare Dual Complete Choice (PPO D-SNP) 4 out of 5 stars UnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-046. $ 0.00 Monthly Premium Colorado Counties Served 2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Chronic Complete (PPO C-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $0.Medicare Advantage Plan Benefit Details in Plain Text. The following Medicare Advantage plan benefits apply to the UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271 - 046) in Denver, Colorado . This plan is administered by CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO..TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL): Plan ID: H0271-060-001. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. New York Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today.UnitedHealthcare - H0271 En el año 2023, UnitedHealthcare - H0271 recibió las siguientes Calificaciones con Estrellas de Medicare: Calificación General por Estrellas: 4 estrellas Calificación de los Servicios de Salud: 3.5 estrellas Calificación de los Servicios de Medicamentos: 3 estrellasCopayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $1000.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined.Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...Y0066_SB_H0271_006_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-046-000 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals.2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Location: Grant, New Mexico Click to see other locations. Plan ID: H0271 - 034 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711. Jan 1, 2023 · Y0066_SB_H0271_016_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-046-000 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals.Evidence of Coverage 2023 UnitedHealthcare® Chronic Complete Assure (PPO C-SNP) Toll-free 1-877-370-3249, TTY 711 24 hours a day, 7 days a week myUHCMedicare.com Y0066_EOC_H0271_036_000_2023_Co UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ FemeninoUnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-046. $ 0.00.Medicare Advantage plan with prescription drugs Summary of benefits 2022 UnitedHealthcare Dual Complete® (HMO D-SNP) H0624-001-000 Look inside to take advantage of the health services and drug coverages the plan provides.UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Location: Grant, New Mexico Click to see other locations. Plan ID: H0271 - 034 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711. The UnitedHealthcare Dual Complete Choice (PPO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply. The average monthly premium for Medicare Advantage plans in Denver is $13.91 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Denver County have an average Medicare Star Rating of 3.78 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare ... Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear h0271-046-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan.Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud queMedicare Advantage plan with prescription drugs Summary of benefits 2022 UnitedHealthcare Dual Complete® (HMO D-SNP) H0624-001-000 Look inside to take advantage of the health services and drug coverages the plan provides. h0271-043-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan.UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ...Y0066_SB_H0271_027_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. 533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ...Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ...Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Choice (PPO D-SNP) Location: Denver, Colorado Click to see other locations. Plan ID: H0271 - 046 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHC.com/Medicare Y0066_SB_H0271_046_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for a complete list of covered services, limitations and exclusions. The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined.2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (PPO D-SNP) Location: Kanawha, West Virginia Click to see other locations. Plan ID: H0271 - 013 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 287Y0066_SB_H0271_023_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ... Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...h0271-043-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan.Navigate to the CMS Enterprise Portal public home page. Login using your user ID and password. The CMS Enterprise Portal My Portal page is displayed, as shown in Figure 59: My Portal Page – My Profile Drop-down. Select the down arrow icon that appears next to your name at the top of page. Then select My Profile from the drop-down list to ... The UnitedHealthcare Dual Complete Choice (PPO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.2023 Colorado UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: Plan H0271-046-000 Subject: UnitedHealthcare Community Plan of Colorado manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Please make sure to always validate eligibility and benefits before providing service.533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ...H0271 027 * 4. Christian. UnitedHealthcare; UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Local PPO Chronic or Disabling Condition $ 9.80 $ 505.00 No; DS H0271; UnitedHealthcare Chronic Complete Assure (PPO C-SNP) 4 out of 5 stars. UnitedHealthcare Chronic Complete Assure (PPO C-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-027. $ 9.80. Monthly Premium.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ FemeninoY0066_SB_H0271_023_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageSheet1 CY2023 Medicare Advantage Special Needs Plans Data as of September 6, 2022. Includes all CY2023 approved contracts/plans. Employer sponsored plans (800 series) are excluded. Plans under sanction are not shown. Notes: Data are subject to change. All contracts for CY2023 have been finalized...Medicare Advantage plan with prescription drugs Summary of benefits 2022 UnitedHealthcare Dual Complete® (HMO D-SNP) H0624-001-000 Look inside to take advantage of the health services and drug coverages the plan provides. Number of Members enrolled in this plan in (H0271 - 036): 2,359 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 287Y0066_EOC_H0271_046_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Coberturao UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear Creek, Conejos, Costilla, Crowley, Custer, Denver, Douglas, El Paso, Elbert, Fremont, Gilpin, Grand, Huerfano, Jefferson, Lake, Larimer, Las Animas, Lincoln, Logan, Morgan, Otero, Park, Pueblo, Teller, Washington, Weld countiesCopayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageResumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que H0271 - 060 - 1 Click to see other plans: Member Services: 1-800-514-4912 TTY users 711 — Enrollment Options — Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance: Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit details Number of Members enrolled in this plan in (H0271 - 027): 4,053 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-000UnitedHealthcare offers UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-046-000 plans for Colorado and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.H0271 - 060 - 1 Click to see other plans: Member Services: 1-800-514-4912 TTY users 711 — Enrollment Options — Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance: Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit details Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage8 a.m.-8 p.m. local time, 7 days a week UHC.com/Medicare Y0066_SB_H0271_046_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for a complete list of covered services, limitations and exclusions.Number of Members enrolled in this plan in (H0271 - 036): 2,359 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...H0271 027 * 4. Christian. UnitedHealthcare; UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Local PPO Chronic or Disabling Condition $ 9.80 $ 505.00 No; DS H0271; Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Y0066_SB_H0271_006_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Location: Grant, New Mexico Click to see other locations. Plan ID: H0271 - 034 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711.

TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both .... Used cars at carmax under dollar10 000

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Jan 1, 2023 · Y0066_SB_H0271_023_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... Number of Members enrolled in this plan in (H0271 - 036): 2,359 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Jan 1, 2023 · Y0066_SB_H0271_005_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $1000.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244The following Medicare Advantage plan benefits apply to the UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271 - 046) in Denver, Colorado . This plan is administered by CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.. To switch to a different Medicare Advantage plan or to change your location, click here. 28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 2872023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Y0066_SB_H0271_046_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Balance (PPO D-SNP) Location: Litchfield, Connecticut Click to see other locations. Plan ID: H0271 - 059 - 0 Click to see other plans. Member Services: 1-866-272-1967 TTY users 711.2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State..

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