Transcription
2022 MedicareAdvantage Plan OverviewFloridaSeptember 2021 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 10012021
Agenda1. Medicare Advantage plan types2. Overview: Dual Special Needs Plans D-SNP3. Get ready for Medicare’s Annual Enrollment Period Verify your participation status4. Recognizing our plans Member ID cards Medicare National Network Passport travel benefit5. Doing business with us6. Available 2022 state plans 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120212
Our MissionTo help people live healthier lives and to help the healthcare system work better for everyone
UnitedHealthcareMedicare Advantageplan typesHealth Maintenance Organization(HMO) – A defined network ofcontracted physicians and facilities toprovide carePoint of Service (HMO-POS) –Includes all the features of an HMO plusthe ability for members to go outside thecontracted network for certain healthcare services — typically at a highercost. POS plans do not require referralsfor specialty care. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120214
UnitedHealthcare Medicare Advantageplan types (cont.)Preferred Provider Organization (PPO) – Offers members access to a networkof contracted physicians and facilities, but also allows them the flexibility to seekcovered services from outside the contracted network, usually at a higher cost.Members do not need a referral for specialty care. PPO plans are available as either local PPO (LPPO) (certain counties within astate) or regional PPO (RPPO) offerings. RPPO plans serve a largergeographic area — either a single state or a multi-state area. RPPO plans offerthe same premiums, benefits and cost-sharing requirements to all members inthe region.Private Fee-for-Service (PFFS) – Allows members to seek care from anyMedicare-eligible care provider, as long as the care provider agrees to the plan'sterms, conditions and payment rates. PFFS plans do not require referrals. Includes a wide variety of health care benefits, often at a lower cost thanOriginal Medicare 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120215
Dual Special NeedsPlans (D-SNP) D-SNP are health care plans for peoplewho qualify for both Medicare andMedicaid Most of our D-SNP plans use the samein-network participating health careprofessionals as our other MedicareAdvantage plans Our D-SNP, UnitedHealthcare DualComplete , serves eligible individualsin 40 states and Washington, D.C. Please visit the My Practice Profile tool onUHCprovider.com/mypracticeprofileto verify your participation status 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120216
States with D-SNP eligible plans Alabama Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii neMarylandMichiganMississippiMissouri 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 10012021 MontanaNebraskaNorth CarolinaNew JerseyNew YorkNevadaOhioOklahomaPennsylvaniaRhode IslandSouth Carolina South aWest VirginiaWyoming7
D-SNP plan process We reimburse health care professionals according to theirapplicable Medicare Advantage Participation Agreement You may be required, at a minimum, to enroll/register withthe state Medicaid plan for Medicare secondary cost sharebilling purposesMemberMedicare andMedicaidcovered benefitMedicaid-onlybenefit– Check with your state for specific requirementsMA paysprimary Not every service provided under D-SNP will requiresubmission of a secondary claim to the Medicaid payerMedicaid payssecondaryMedicaidcovers at 100% Medicaid is always the payer of last resort andMedicare benefits should be exhausted firstbefore Medicaid coverage starts Supplemental benefits also follow the sameprocess — check with your state for MedicaidrequirementsQuestions?State-specific training and information is available at UHCprovider.com/plans choose your state Medicare 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120218
Getting ready for the AnnualEnrollment PeriodWhat is the Annual Enrollment Period (AEP)?Medicare’s AEP is Oct. 15–Dec. 7 each year. Medicare-eligible enrollees canenroll, switch or drop a Medicare Advantage plan or stand-alone prescriptiondrug plan for the upcoming calendar year.More informationUnitedHealthcare plan information is available at UHCprovider.com/plans choose your state Medicare.More information on Medicare’s AEP is available at medicaremadeclear.com. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 100120219
Verify your Medicare Advantageparticipation status If you participate in UnitedHealthcare Medicare Advantage benefit plans, you’llparticipate in UnitedHealthcare D-SNP (unless your Participation Agreement excludesthem). To review your participation status, sign in at UHCprovider.com/mypracticeprofile.– Participation is based on your tax ID number (TIN)– Participation shown in My Practice Profile includes all service locations for your TIN If you have questions about your Participation Agreement, please contact your NetworkManagement representative. To find your Network Management representative, go toUHCprovider.com/contactus Find a Network Contact. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202110
Verify your Medicare National Networkparticipation status Participation with our Medicare National Network (HMO and PPO) will be displayed inMy Practice Profile if the plan is offered in your service location county You may deliver care to members from other states who are enrolled in aUnitedHealthcare Medicare Advantage plan with the Medicare National Network logo Verify the member’s eligibility by checking their UnitedHealthcare ID card for theMedicare National Network logo 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202111
Recognizing our plans
UnitedHealthcare Medicare AdvantageID cardsSample member ID cards for illustration only; actual information varies depending on payer, plan and other requirements. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202113
New for 2022 – UnitedHealthcareUCard UnitedHealthcare is redesigning some member ID cards You and your office staff don’t have to do anything differently Beginning Jan. 1, 2022, members enrolled in various plans in Illinois, Iowa,Minnesota, Nebraska, North Dakota, South Dakota and Wisconsin mayshow you the redesigned member card The UCard will have the information you need to verify eligibility and should beused the same as any other UnitedHealthcare member ID cardSample member ID cards for illustration only; actual information varies depending on payer, plan and other requirements. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202114
UnitedHealthcare MedicareNational Network UnitedHealthcare offers eligible members access to thelargest Medicare Advantage network through theUnitedHealthcare Medicare National Network Eligible Medicare Advantage HMO and PPO plan membershave nationwide access to care at in-network costs The National Network is not available for all plans If the member’s plan has the Medicare National Network,the ID card will have the logo Members with the Medicare National Network will not need toactivate Passport Medicare National Network size varies by market, due tocontract variationsSample member ID cards for illustration only; actualinformation varies depending on payer, plan and otherrequirements. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202115
UnitedHealthcareMedicare NationalNetwork (cont.) Prior authorization and advance notificationrequirements for Medicare Advantage plansstill apply for all plans Primary care providers (PCPs) for referralrequired HMO plans should still coordinatecare and submit referrals for specialistservices inside the member’s service area Plan members are encouraged to select andremain with a PCP inside their plan’s localservice area Referrals are not required for eligible HMOplan members using the Medicare NationalNetwork to receive care outside their localservice area 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202116
Medicare National Network (HMO andPPO)These states have an eligible Medicare Advantage HMO or PPO plan withMedicare National Network tDelawareDistrict ofColumbia Florida sachusettsMaineMaryland MichiganMississippiMissouriMontanaNebraskaNorth CarolinaNew JerseyNew YorkNevadaOhio OklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahWashington Wisconsin Virginia WestVirginia WyomingIndividual Medicare Advantage plans with the Medicare National Network aren’t currently available to residentsof Alaska and Louisiana. However, we’re developing the network in those states and members of plans with theMedicare National Network may seek care from any contracted, participating health care professional. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202117
Passport travel benefit Health care professionals must be contractedwith UnitedHealthcare Medicare Advantage toprovide services to members who use the Passporttravel benefit To learn more about Passport, visitUHCprovider.com/plans choose your state Medicare Select Plan Name Tools & ResourcesSample member ID cards for illustration only;actual information varies depending on payer,plan and other requirements. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202118
Doing business with us
UnitedHealthcare ProviderPortal The UnitedHealthcare Provider Portal is your gateway to UnitedHealthcare online tools To sign in, go to UHCprovider.com and click on the Sign In button in the top-right cornerYou can: Check patient eligibility and benefits Use TrackIt to manage items that need your attention, including prior authorization requestsand claim submissions Submit and check referral status Get claims status and submit reconsideration and appeal requestsVisit UHCprovider.com/portal for more information.If you have technical questions contact UnitedHealthcare Web Support atProviderTechSupport@uhc.com or call 866-842-3278, option 1, from 7 a.m.‒9 p.m. CT,Monday‒Friday. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202120
Update demographics throughMy Practice Profile The My Practice Profile tool on the UnitedHealthcare Provider Portal lets youview, update and attest to the health care professional demographicinformation UnitedHealthcare members see for your organization Make demographic changes just one time, in one place — and get thoseupdates into our systems more quickly You’ll find more information, instructions and training atUHCprovider.com/mypracticeprofile To review your participation status, sign in atUHCprovider.com/mypracticeprofile– Choose View Provider Details next to an individual in your practice– View Provider Products to see participation status 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202121
ClaimsInstructions and links can be found at UHCprovider.com/claims.Visit UHCprovider.com/edi for information about connecting your vendor or clearinghouse.Standard timely filing is 90 days from the date of service or the time frame in your UnitedHealthcareParticipation Agreement.Submitting claims Online: To submit claims using the Claims tool in the UnitedHealthcare Provider Portal, please goto UHCprovider.com and click on the Sign In button in the top-right corner Electronic: To submit claims by Electronic Data Interchange (EDI), please use Payer ID 87726 Paper: Please submit paper claims to the address listed on the member’s ID cardResubmitting claims Use the Claims tool in the UnitedHealthcare Provider Portal or your EDI clearinghouse 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202122
Electronic payments To speed up payments to your practice, UnitedHealthcare is phasing out paper checksand moving to digital transactions, where not prohibited by law You’ll need to choose between 2 options for receiving payment fromUnitedHealthcare — ACH/direct deposit or virtual card payments. Both of these arefacilitated by Optum Pay on behalf of UnitedHealthcare. If your practice/health care organization is already enrolled and receiving claim paymentsthrough ACH/direct deposit, there is no action you need to take 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202123
UHCprovider.com This public website is available 24/7 and doesn’t require registration to access You’ll find valuable resources including administrative and plan-specific policies,protocols and guides, health plans by state, regulatory and practice updates,quality programs, efficiency reports and moreEducation and training at UHCprovider.com/training To help ensure you are reimbursed quickly and patients get access to the carethey need, we have developed a full range of training resources for health careprofessionals Training content is updated frequently and is organized by categories to make iteasy to find what you need Topics include the digital solutions available on the Provider Portal, plan andproduct overviews, clinical tools, state-specific training and much more 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202124
UHCprovider.com/newsOn UHCprovider.com/news, you’ll find updates across our commercial, MedicareAdvantage and Community Plan (Medicaid) health plans — from new resourcesand program updates to process changes and reminders.Policy and protocol updates Contractual and regulatory updates, as well as policy, protocol, program andadministrative procedures, are released on the first day of every month Filter the notifications based on your state, point of care and specialtyMedical Policy Update Bulletin Monthly Medical Policy Update Bulletins notify network health care professionalsabout changes to medical policies, medical benefit drug policies, coveragedetermination guidelines and utilization review guidelines Filter by Medical Policy or Policy and Protocol 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202125
Medicare AdvantagePlans in Florida 2021 United HealthCare Services, Inc. All Rights Reserved.PCA-1-21-03465-M&R-PRES 10012021
2o22 Florida overviewIn Florida, we will offer the following Medicare Advantage plans:1.AARP Medicare Advantage (HMO)2.AARP Medicare Advantage Plan 2 (HMO)3.AARP Medicare Advantage (HMO-POS)4.AARP Medicare Advantage Focus (HMO-POS)5.AARP Medicare Advantage Choice (PPO)6.AARP Medicare Advantage Choice Plan 2 (Regional PPO)7.AARP Medicare Advantage Patriot (Regional PPO)8.UnitedHealthcare The Villages Medicare Advantage (HMO)9.UnitedHealthcare Medicare Advantage Walgreens (HMO C-SNP) 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202127
Florida 2022 expansionAARP Medicare Advantage (HMO) will beoffered in Palm Beach CountyHolmesEscambiaSanta RosaJacksonOkaloosaWaltonWashingtonHamiltonBay CMS Contract H1045-055 Group number 78615, llaUnionLafayetteClayBradfordGilchristSt. JohnsAlachuaDixiePutnam 0 premiumFlaglerLevyMarion Open access – UnitedHealthcare MedicareNational ge 0 RX deductible – Tiers 1,2 covered through the gapPascoOsceola OTC Catalog offered through FirstLine BenefitsPinellasHillsboroughBrevardPolkIndian River 60 per quarter, credit expires at the end ofeach quarterManateeHardeeOkeechobeeSt. LucieHighlandsSarasotaDe SotoMartin UnitedHealthcare Dental – Level 3: up to 1,000yearly for covered preventive and comprehensivedental services 0 preventive and diagnosticCharlotteGladesPalm BeachLee2022 Medicare Advantage HMOExpansion – New PlanHendryBrowardCollierMonroe 0 – 50% comprehensive 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 10012021Dade28
Florida 2022 expansionAARP Medicare Advantage (HMO)plan is expanding into Bradford, Dixie, andUnion countiesHolmesEscambiaSanta aTaylorCMS contract christGroup numbers 82951, 82969DuvalBakerSuwanneeWakullaSt. ellasHillsboroughBrevardPolkIndian RiverManateeHardeeOkeechobeeSt. LucieHighlandsSarasotaDe SotoMartinCharlotteGladesPalm BeachLee2022 Medicare Advantage HMOExpansion – New PlanExisting Medicare Advantage HMO 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 10012021HendryBrowardCollierMonroeDade29
Florida 2022 expansionAARP Medicare Advantage Plan 2 (HMO)plan is expanding into Glades and HendrycountiesHolmesEscambiaSanta CalhounLibertyCMS contract roup numbers 82953, 82962DuvalBakerSuwanneeWakullaSt. ellasHillsboroughBrevardPolkIndian RiverManateeHardeeOkeechobeeSt. LucieHighlandsDe SotoSarasotaMartinCharlotteGladesPalm BeachHendryLee2022 Medicare Advantage ExpansionBrowardCollierExisting Medicare AdvantageMonroeDade 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202130
Florida 2022 expansionAARP Medicare Advantage (HMO-POS)plan is expanding into Baker CountyHolmesEscambiaSanta miltonBayJeffersonMadisonDuvalCMS contract GulfGroup numbers 82995, hristClaySt. ellasHillsboroughBrevardPolkIndian RiverManateeHardeeOkeechobeeSt. LucieHighlandsSarasotaDe SotoMartinCharlotteGladesPalm BeachLeeHendry2022 Medicare Advantage ExpansionBrowardCollierExisting Medicare AdvantageMonroeDade 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202131
Florida 2022 expansionAARP Medicare Advantage Focus(HMO-POS) plan is expanding intoOkeechobee CountyHolmesEscambiaSanta aTaylorCMS contract christGroup numbers 70340, 82970DuvalBakerSuwanneeWakullaSt. ellasHillsboroughBrevardPolkIndian RiverManateeHardeeOkeechobeeSt. LucieHighlandsSarasotaDe SotoMartinCharlotteGladesPalm BeachLeeHendry2022 Medicare Advantage ExpansionBrowardCollierExisting Medicare AdvantageMonroeDade 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202132
Florida 2022 expansionAARP Medicare Advantage Choice (PPO)plan is expanding into Dixie and GilchristcountiesHolmesEscambiaSanta LibertyCMS contract christGroup numbers 70343, 82131DuvalBakerSuwanneeWakullaSt. ellasHillsboroughBrevardPolkIndian RiverManateeHardeeOkeechobeeSt. LucieHighlandsSarasotaDe SotoMartinCharlotteGladesPalm BeachLeeHendry2022 Medicare Advantage LPPO ExpansionBrowardExisting Medicare Advantage LPPOCollierMonroeDade 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202133
Navigate4Me Members in certain plans with any of thefollowing qualifying health events are eligible forprogram that helps members manage chronicconditions. These members are eligible to workwith a dedicated UnitedHealthcare Navigator. New cancer diagnosis within the last 60 days Cardiac event like a heart attack or strokewithin the last 30 days Musculoskeletal event like a joint replacementsurgery (i.e., hip or knee), chronic back pain(i.e., actively in therapy) or treatment for arecent fall 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202134
UnitedHealthcare HouseCallsThe basics Annual in-home visit Licensed health care practitioner Helps to close care opportunitiesMajor milestones 10 million visits Virtual Visit expansion 99% member satisfaction 91% repeat visit 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202135
2022 Medicare Advantagegeneral plan updates All plans – Tier 1 covered through gap All plans – 0 copays for labs and many preventive tests like colonoscopies and mammograms All plans – 375– 1,425 copay for each hearing device, limited to 2 devices every year All plans – Medical telehealth services 0 copay with any contracted health care professionalBehavioral health telehealth services 0 copay with Optum Behavioral Health Most all HMO and C-SNP plans will be on the UnitedHealthcare National Network offeringnationwide access to care at in-network costs- HMO: H1045-025, H1045-026, H1045-028, H1045-030, H1045-031, H1045-032, H1045-033,H1045-034, H1045-041, H1045-042, H1045-043, H1045-055- C-SNP: H1045-048-001, H1045-048-002, H1045-048-003, H1045-048-004 Plans H1045-036 and H1045-045 continue to have Passport (visitor travel) package 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202136
Social and government programsEligibility for these programs does notdepend on being a UnitedHealthcaremember. Medicare savings programs for assistancepaying Medicare Part B premiums Community-based services designed to lowercosts related to transportation, nutrition, energyand phone bills and more Recertification or reapplication programs helpmembers through the application processSome UnitedHealthcareMedicare Advantage andDual Complete planmembers may be eligible forassistance programs andservices like these offered bythe community, state orfederal governments. Low-income subsidy program helps memberswith prescription drug costs Veteran chart collection brings together chartsfrom Department of Veterans Affairs (VA)medical facilities 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202137
Ancillary benefit overviewDentalSupported in most locationsby the largest nationalMedicare dental network.Coverage outside of thenetwork available based onmarket needs. Network sizevaries by plan and by market.VisionEyewear allowances withstandard lenses included,supported by a broad retailnetwork and convenienthome delivery optionsHearingWith UnitedHealthcare Hearing,eligible plan members haveaccess to routine hearingexams, custom-programmedhearing aids and professional,nationwide support for theirhearing needsRenew Active fitnessprogramThe gold standard ofMedicare fitness programsfor body and mind includesthe largest gym network aswell as access to thousandsof online workoutsFitbit activity trackerHelps members stay activeby tracking their activity,sleep, and more with a free*Fitbit activity trackerAcupuncture, chiropracticcare, naturopathyAdditional services not coveredunder Original Medicare for therelief of pain. No referralnecessary. 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202138
Ancillary benefit portfolio overviewTransportationNon-emergency rides to adoctor’s office, pharmacy, orother approved locations atno additional costNurseLine24/7 access for members toa registered nurse who canprovide ongoing health andnavigational support forexisting or sudden-onsethealth concernsMealsPost-discharge meal delivery tohelp ensure propernourishment after dischargefrom inpatient hospitalization ora skilled nursing facilityOver-the-counter (OTC)catalog and prepaid cardA broad selection of brandname and private-label OTCproducts with easy catalogordering online, by phone, ormail-order with fast homedeliveryHealthy FoodA monthly credit added tothe OTC prepaid card formembers in participatingD-SNP plans to buy fruits,vegetables, meat, seafood,dairy and morePersonal emergencyresponse systemIn-home monitoring device thatprovides members withconfidence of knowing theyhave access to help 24/7 2021 United HealthCare Services, Inc. All Rights Reserved. PCA-1-21-03465-MR-PRES 1001202139
2022 Product BenefitsFlorida CentralWalgreensPreferredNationalNetwork 35 InsulinPlan NameAARP Medicare Advantage (HMO-POS)UnitedHealthcare Medicare Advantage Walgreens (HMO CSNP)AARP Medicare Advantage Choice (PPO)Plan IDH1045-030-000H1045-048-001H2406-010-000Plan Highlights 0 premium plan with 0 Rx deductible and rich ancillary benefits.POS for dental only 0 premium plan designed to help individuals manage chronicconditions 0 premium, open access plan for those who are cost conscious,but want provider choice and additional ancillary benefitsService AreaFlorida: Brevard, Orange, Osceola, SeminoleFlorida: Brevard, Orange, Osceola, Seminole, VolusiaFlorida: Brevard, Orange, Osceola, SeminolePremium 0 0 0Medical Deductible 0 0 0Max OOP 3,900 3,900 5,900PCP/Specialist 0 / 20; Referral Required 0 / 25; Referral Required 5 / 35; No Referral RequiredInpatient Hospital 195 Days 1-5 175 Days 1-6 295 Days 1-6ASC/Outpatient 0 or 100 / 0 or 195 0 or 75 / 0 or 175 0 or 150 / 0 or 270Telehealth 0 Virtual Medical & Mental Health Visits 0 Virtual Medical & Mental Health Visits 0 Virtual Medical & Mental Health VisitsLab Copay 0 0 0Rx Ded.; Copays 0 All Tiers; 3/ 10/ 45/ 95/33%; Tier 1 Full Gap Coverage 150 Tiers 4-5; 0/ 0/ 47/ 100/30% (Preferred); Tier 1 Full GapCoverage 150 Tiers 3-5; 3/ 10/ 45/ 95/30%; Tier 1 Full Gap CoverageDental 1,000 Dental Level 3 ( 0-50% cost sharing)Dental Level 1 (no cost sharing)Dental Level 1 (no cost sharing)EyewearUp to 200 per year, standard lenses at no costUp to 200 per year, standard lenses at no costUp to 200 every 2 years, standard lenses at no costFitnessRenew Active Fitness ProgramRenew Active Fitness ProgramRenew Active Fitness ProgramOTC 40/quarter OTC catalog 100/quarter OTC catalog 40/quarter OTC catalogHearing Aid 375 - 1,425 copay per device; 2 devices every year 375 - 1,425 copay per device; 2 devices every year 375 - 1,425 copay per device; 2 devices every yearOther BenefitsNurselineNurseline PERSNurselinePlan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing and Dual eligible benefits represent Full Duals and QMBs. Benefits and features vary by plan. Limitations and exclusions apply. 2021 United HealthCare Services, Inc. All rights reserved. Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group.
2022 Product BenefitsFlorida EastWalgreensPreferredNationalNetwork 35 InsulinPlan NameAARP Medicare Advantage Focus (HMO-POS)AARP Medicare Advantage (HMO-POS)AARP Medicare Advantage (HMO-POS)Plan IDH1045-036-000H1045-028-000H1045-030-000Plan Highlights 0 premium plan designed around St. Lucie for coordinated care,low out-of-pocket costs, access to statewide network of hospitalsand specialists. POS for dental only. Passport included 0 premium plan with 0 Rx deductible and rich ancillary benefits.POS for dental only 0 premium plan with 0 Rx deductible and rich ancillary benefits.POS for dental onlyService AreaFlorida: Indian River, Martin, Okeechobee, St. LucieFlorida: Charlotte, Hernando, Hillsborough, Indian River, Lee,Manatee, Martin, Pasco, Pinellas, Polk, Sarasota, St. LucieFlorida: Brevard, Orange, Osceola, SeminolePremium 0 0 0Medical Deductible 0 0 0Max OOP 3,400 4,900 3,900PCP/Specialist 0 / 25; No Referral Required 0 / 35; Referral Required 0 / 20; Referral RequiredInpatient Hospital 250 Days 1-6 280 Days 1-6 195 Days 1-5ASC/Outpatient 0 or 150 / 0 or 250 0 or 195 / 0 or 250 0 or 100 / 0 or 195Telehealth 0 Virtual Medical & Mental Health Visits 0 Virtual Medical & Mental Health Visits 0 Virtual Medical & Mental Health VisitsLab Copay 0 0 0Rx Ded.; Copays 0 All Tiers; 3/ 12/ 47/ 100/33%; Tier 1 Full Gap Coverage 0 All Tiers; 3/ 10/ 45/ 95/33%; Tier 1 Full Gap Coverage 0 All Tiers; 3/ 10/ 45/ 95/33%; Tier 1 Full Gap CoverageDental 1,000 Dental Level 3 ( 0-50% cost sharing) 1,000 Dental Level 3 ( 0-50% cost sharing) 1,000 Dental Level 3 ( 0-50% cost sharing)EyewearUp to 200 every 2 years, standard lenses at no costNot CoveredUp to 200 per year, standard lenses at no costFitnessRenew Active Fitness ProgramRenew Active Fitness ProgramRenew Active Fitness ProgramOTC 40/quarter OTC catalog 80/quarter OTC
2022 Medicare Advantage Plan Overview Florida September 2021 . Agenda 2 1. Medicare Advantage plan types 2. Overview: Dual Special Needs Plans D-SNP 3. Get ready for Medicare's Annual Enrollment Period Verify your participation status 4. Recognizing our plans . Medicare-eligible care provider, as long as the care provider agrees to the .
