H0169 002 - UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.

 
H0169-002-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com. Logs

2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000 Jan 1, 2023 · H0169-001-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_001_000_2023_M Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plan for Missouri. Check eligibility, explore benefits, and enroll today.Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_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 complete list of covered services, limitations and exclusions. Aug, 18 2023 — Based on the 2024 Medicare Part D plan bids and June plan enrollment, the 2024 average total Part D premium is projected to be $55.50 per month, a decrease of 1.8 percent from the 2023 average total premium of $56.49.Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, 2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits DetailsUnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. Información sobre proveedores UnitedHealthcare Dual Complete® (HMO-POS D-SNP) Aprovechará los beneficios adicionales de su plan si usa los proveedores indicados a continuaciónUnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan.The following UnitedHealthCare plans are accepted at Oak Street Health locations. Plan Name. Effective Year. Benefit Package. Summary. AARP Medicare Advantage. 2023. H1944-024. AARP Medicare Advantage.H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 14,549 members. There are 131 members enrolled in this plan in Lawrence, Missouri, and 15,275 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ... Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000 We would like to show you a description here but the site won’t allow us.H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_M2018 UnitedHealthcare Dual Complete (HMO SNP) - H0169-002-0 in MO Plan Benefits Details 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals. 2018 UnitedHealthcare Dual Complete (HMO SNP) - H0169-002-0 in MO Plan Benefits DetailsUnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Sanctioned Plan The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Formulary Drugs Starting with the Letter A in Howard County, MO: CMS MA Region 15 which includes: MO: Drugs Starting with Letter A Drug Name Drug Tier Information Cost-Sharing Drug Usage Mgmt; Tier Nbr. Tier 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals. Number of Members enrolled in this plan in (H0169 - 004): 1,480 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security Number2022 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans. UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169-002-000 2023 Plan Details and Costs Learn More about UnitedHealthcare UnitedHealthcare Dual Complete (HMO-POS D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169-002-000 2023 Plan Details and Costs Learn More about UnitedHealthcare UnitedHealthcare Dual Complete (HMO-POS D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, 2021 UnitedHealthcare (H0169) Star Rating Details; UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Benefit Details The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) in Lafayette, MO: CMS MA Region 15 which includes: MO Plan Monthly Premium: $30.50 Deductible: $445: Star Rating Category & Measures: 2021: 20202020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits DetailsThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 001) currently has 14,992 members. There are 15 members enrolled in this plan in Hancock, Iowa, and 14,934 members in Iowa. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 14,549 members. There are 131 members enrolled in this plan in Lawrence, Missouri, and 15,275 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ...4.5 out of 5 stars* for plan year 2023. $0.00 Monthly Premium. UnitedHealthcare Dual Complete (HMO-POS D-SNP) is a HMO-POS D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0169-002-000.The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 24,875 members. There are 168 members enrolled in this plan in Barry, Missouri, and 24,793 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as follows:2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Explained 2023 Evidence of Coverage for UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Table of Contents Questions? Call Customer Service at 1-866-842-4968, TTY 711, 8am-8pm: 7 Days Oct-Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-006-000 plan for Nebraska. Check eligibility, explore benefits, and enroll today. The UnitedHealthcare Dual Complete LP1 (HMO-POS 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. Y0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageGuía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates,8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_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 complete list of covered services, limitations and exclusions.o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 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 002 hamaspik, inc. fide 001 ny h0111 004 wellcare of georgia, inc. ga h0154 012 viva health, inc. al 019 h0169 unitedhealthcare of the midwest, inc. ia ks hide 003 h0174 wellcare of texas, inc. 006 h0251 005 unitedhealthcare plan of the river valley, inc. tn h0270 wellcare health insurance company of america ar h0271 023 014 ct in me 020 028 mi ...The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 14,549 members. There are 131 members enrolled in this plan in Lawrence, Missouri, and 15,275 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ...The UnitedHealthcare Dual Complete (HMO SNP) (H0169 - 002) currently has 8,801 members. There are 28 members enrolled in this plan in Barry, Missouri, and 8,695 members in Missouri. Prescription Drug Coverage: Deductible, Cost-sharing, Formulary: This plan has a $415 deductible. So, you are 100% responsible for the first $415 in medication costs.Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageH0169-002-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com2019 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com 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_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage H0169-002 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. Our plan is a Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization) with a Point-of-Service (POS) option approved by Medicare and run by a private company. H0169-002-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.comY0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageJan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, 2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating DetailsLearn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-008-000 plan for Missouri. Check eligibility, explore benefits, and enroll today. Y0066_EOC_H0169_004_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare - H0169 For 2023, UnitedHealthcare - H0169 received the following Star Ratings from Medicare: Overall Star Rating: 4.5 stars Health Services Rating: 4 stars Drug Services Rating: 4 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 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating Details H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_M2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... UnitedHealthcare - H0169 For 2023, UnitedHealthcare - H0169 received the following Star Ratings from Medicare: Overall Star Rating: 4.5 stars Health Services Rating: 4 stars Drug Services Rating: 4 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 ...H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H0169_002_000_2022_M. www.UHCCommunityPlan.comH0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_M002 hamaspik, inc. fide 001 ny h0111 004 wellcare of georgia, inc. ga h0154 012 viva health, inc. al 019 h0169 unitedhealthcare of the midwest, inc. ia ks hide 003 h0174 wellcare of texas, inc. 006 h0251 005 unitedhealthcare plan of the river valley, inc. tn h0270 wellcare health insurance company of america ar h0271 023 014 ct in me 020 028 mi ...Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, 2023 Missouri UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: H0169-002-000 Subject: UnitedHealthcare Community Plan of Missouri manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Created Date: 20230218034507Z Sep 26, 2022 · H0169-008-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_008_000_2023_M o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 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 Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.The UnitedHealthcare Dual Complete (HMO SNP) (H0169 - 002) currently has 8,801 members. There are 28 members enrolled in this plan in Barry, Missouri, and 8,695 members in Missouri. Prescription Drug Coverage: Deductible, Cost-sharing, Formulary: This plan has a $415 deductible. So, you are 100% responsible for the first $415 in medication costs.Jan 1, 2023 · H0169-004-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_M UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan.H0169-002-000 MO99MODSNPF MO99MODSNPP MO99MODSNPQ ... H0169-008-000 MO99MODSNP3F MO99MODSNP3P MO99MODSNP3Q UnitedHealthcare Dual Complete® Choice (PPO D-SNP) The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 14,549 members. There are 131 members enrolled in this plan in Lawrence, Missouri, and 15,275 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ...2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. Y0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2018 UnitedHealthcare Dual Complete (HMO SNP) - H0169-002-0 in MO Plan Benefits Details2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating Details 2021 UnitedHealthcare (H0169) Star Rating Details; UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Benefit Details The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) in Lafayette, MO: CMS MA Region 15 which includes: MO Plan Monthly Premium: $30.50 Deductible: $445: Star Rating Category & Measures: 2021: 2020The UnitedHealthcare Dual Complete LP1 (HMO-POS 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.

o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 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. Kristie

h0169 002

Jan 1, 2023 · H0169-004-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_M Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169-002-000 2023 Plan Details and Costs Learn More about UnitedHealthcare UnitedHealthcare Dual Complete (HMO-POS D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security NumberMaximum 3 visits every year. 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 $4000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, 2021 UnitedHealthcare (H0169) Star Rating Details; UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Benefit Details The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) in Lafayette, MO: CMS MA Region 15 which includes: MO Plan Monthly Premium: $30.50 Deductible: $445: Star Rating Category & Measures: 2021: 2020UnitedHealthcare Community Plan Maximum 3 visits every year. 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 $4000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.H0169-002 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. Our plan is a Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization) with a Point-of-Service (POS) option approved by Medicare and run by a private company. 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Plan 1 (HMO D-SNP) Location: Butler, Nebraska Click to see other locations. Plan ID: H0169 - 003 - 0 Click to see other plans. Member Services: 1-844-368-7149 TTY users 711. Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_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 complete list of covered services, limitations and exclusions. H0169-001-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_001_000_2023_M.

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