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UnitedHealthcare Enrollment Service Area Nationwide UnitedHealthcare Group
The Value of UnitedHealthcare and the PHIP Partnership National coverage that follows you where ever you are World-wide emergency coverage 24 hour NurseLine Care and Disease Management Programs Additional benefits for Medicare participants including: Routine podiatry coverage Routine vision coverage
UnitedHealthcare Group Medicare Advantage (PPO) plan
UnitedHealthcare Group Medicare Advantage (PPO) plan How Our Plan Works Getting the health care coverage you may need. Coverage for visiting doctors, clinics, hospitals and prescriptions in one plan One ID card and one phone number to call No referral needed to see a specialist See doctors outside the network for the same cost share as innetwork providers as long as the provider accepts Medicare and the plan
UnitedHealthcare Group Medicare Advantage (PPO) plan Benefit Coverage Deductible Medical Out-of-Pocket Maximum In-Network Member Responsibility None $2,500 per individual Out-of-Network Primary Care Office Visit $15 copay $15 copay Specialist Office Visit $20 copay $20 copay Inpatient Hospitalization $100 copay per day $300 maximum per admit $100 copay per day $300 maximum per admit Outpatient Surgery $125 copay $125 copay Lab Tests $0 $0 X-ray 10% 10% Pharmacy Pharmacy Out-of-Pocket Maximum 40% of charge up to $250 maximum per 31-day supply $5,100 per individual
UnitedHealthcare Group Medicare Advantage Emergency and Travel Benefits MEMBER PAYS: Urgent Care Emergency Room Ambulance - ground or air Outside of the United States $20 copay $65 copay $50 copay Covers urgent care, emergency and ambulance
UnitedHealthcare Special Programs HouseCalls: With this program, you get an annual in home clinical visit from one of our nurse practitioners at no extra cost. A HouseCalls visit is designed to support but not take the place of your regular doctor s care. SilverSneakers : The SilverSneakers fitness program is designed for all fitness levels and includes access to exercise equipment, classes and more at 13,000+ fitness locations. NurseLine: Whether you have questions about a medication or have a health concern in the middle of the night, registered nurses answer your call 24 hours a day. Virtual Doctor Visits: Lets you see and speak to specific doctors using your computer or a mobile device, like a tablet or smartphone, from wherever you can access a strong Internet connection. Solutions for Caregivers: At no additional cost, Solutions for Caregivers supports you, your family and those you care for by providing information, education, resources and care planning.
UnitedHealthcare Prescription Drug Plan Medicare
Pharmacy Network Benefit UnitedHealthcare Group Formulary The UnitedHealthcare Group Formulary (Drug List): is a list of medications that are covered by the plan The Drug List can be found at: www.uhc.com/pers OptumRx Home Delivery Free standar shipping Up to 3-month supply 24/7 phone support Refill reminders Pharmacy Network Access to 68,000 pharmacies nationwide Network Pharmacies Include* Costco Safeway CVS Pharmacy Walgreens Fred Meyer/Kroger/QFC Walmart Rite Aid Target *Not all contracted network pharmacies are listed. Pharmacies contracted with your health plan may change at any time. Your health plan will notify you if your pharmacy is no longer included in the network. Please contact your health plan for more details.
UnitedHealthcare Non-Medicare Plans
UnitedHealthcare Non-Medicare Plans Benefit Coverage Core Value Plan Qualified HDHP Plan Member Responsibility In-Network Out-of-Network In-Network Out-of-Network Deductible $1,000 per individual $2,000 per family $3,000 per individual $6,000 per family Out-of-Pocket Maximum (includes deductible) $7,350 per individual $14,700 per family $6,650 per individual $13,300 per family Primary Care Office Visit $20 copay 40% after ded. 20% after ded. 40% after ded. Specialist Office Visit $20 copay 40% after ded. 20% after ded. 40% after ded. Inpatient Hospitalization 20% after ded. 40% after ded. 20% after ded. 40% after ded. Outpatient Surgery 20% after ded. 40% after ded. 20% after ded. 40% after ded. Lab Tests 20% 40% after ded. 20% after ded. 40% after ded. X-ray 20% 40% after ded. 20% after ded. 40% after ded. Alternative Care $25 copay 40% after ded. 20% after ded. 40% after ded. Pharmacy Pharmacy Out-of-Pocket Maximum 40% up to $250 maximum per 31-day supply Combined with medical 20% after deductible Combined with medical
UnitedHealthcare Prescription Drug Plan Non-Medicare
Pharmacy Network Benefit UnitedHealthcare Group Formulary The UnitedHealthcare Group Formulary (Drug List): is a list of medications that are covered by the plan The Drug List can be found at: www.uhc.com/pers OptumRx Home Delivery Free standard shipping Up to 3-month supply 24/7 phone support Refill reminders Pharmacy Network Access to 68,000 pharmacies nationwide Network Pharmacies Include* Costco Safeway CVS Pharmacy Walgreens Fred Meyer/Kroger/QFC Walmart Rite Aid Target *Not all contracted network pharmacies are listed. Pharmacies contracted with your health plan may change at any time. Your health plan will notify you if your pharmacy is no longer included in the network. Please contact your health plan for more details.
How We Cover Prescriptions The UnitedHealthcare Prescription Drug List (PDL) is a list of medications that are covered by the plan Medications are placed into tiers that represent the cost you pay out-ofpocket Choosing medications in lower tiers may save you money Tier 1 Lower-cost medications Highest overall value Mostly generics, but some brands Tier 2 Midrange cost medications Good overall value Mix of brands and generics Tier 3 Higher-cost medications Lowest overall value Mostly brands and some generics *Not all contracted network pharmacies are listed. Pharmacies contracted with your health plan may change at any time. Your health plan will notify you if your pharmacy is no longer included in the network. Please contact your health plan for more details.
UnitedHealthcare Digital Access/Tools Non-Medicare
UnitedHealthcare Digital Access/Tools Virtual Visits myuhc.com Healthcare Cost Estimator Mobile App
UnitedHealthcare Provider Search