H5253 041 - Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage

 
o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 . Gfhoklzw

Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 545 members enrolled in this plan in Orange, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. Number of Members enrolled in this plan in (H5253 - 041): 23,173 members : Plan’s Summary Star Rating: 4 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 ... Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 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 ... H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M. www.UHCCommunityPlan.com 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Catawba, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Oak Street Health Gate City accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Greensboro, North Carolina locations accept Part B plans, though some require both Part A and Part B. Need to contact us? Use this reference guide for quick access to a variety of helpful resources. UnitedHealthcare Provider Portal The UnitedHealthcare Provider Portal is your gateway to the 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Durham, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 545 members enrolled in this plan in Orange, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 Service area: North Carolina - Alamance, Alexander, Anson, Bertie, Bladen, Buncombe, Burke, 2022 UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H5253-041-0 in NC Plan Benefits Details H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M Need to contact us? Use this reference guide for quick access to a variety of helpful resources. UnitedHealthcare Provider Portal The UnitedHealthcare Provider Portal is your gateway to the H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M 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. Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 plan for North Carolina. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. 3 Your Summary of Benefits “Medicare & You” handbook. View it online at www.medicare.gov or get a copy by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M. www.UHCCommunityPlan.com Number of Members enrolled in this plan in (H5253 - 041): 23,173 members : Plan’s Summary Star Rating: 4 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 ... 2022 UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H5253-041-0 in NC Plan Benefits Details 2022 UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H5253-041-0 in NC Plan Benefits Details Y0066_ANOC_H5253_041_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ... Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Details. Dental care. In-Network: Preventive Dental: Maximum Plan Allowance of $1500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Comprehensive Dental: Copayment for Medicare-covered Benefits $30.00. Sep 1, 2023 · UnitedHealthcare Dual Complete (HMO-POS D-SNP) You're viewing plan details for. 27053 Alamance County. Update your ZIP Code to view accurate plan details for your area. Monthly Premium. $ 0 - $ 38.40. Primary Care Provider. $ 0 copay - 20 % of the cost. Out-of-Pocket Maximum. Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 2,168 members enrolled in this plan in Buncombe, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. Original Medicare. Dr. Miller accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Durham, North Carolina locations accept Part B plans, though some require both Part A and Part B. Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... Jan 1, 2023 · H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M H5253-041: Download: AARP Medicare Advantage Walgreens (HMO-POS) 2023: H5253-110: Download: UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) 2023: R1548-001: Download: AARP Medicare Advantage Plan 3 (HMO-POS) 2023: H5253-117: UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) 2023: H5253-116: UnitedHealthcare Dual Complete Choice (PPO ... Original Medicare. Oak Street Health High Point accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our High Point, North Carolina locations accept Part B plans, though some require both Part ... Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 plan for North Carolina. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M. www.UHCCommunityPlan.com o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number Jan 1, 2023 · Summary of Benefits 2023 AARP® Medicare Advantage Plan 1 (HMO-POS) H5253-111-001 Look inside to take advantage of the health services and drug coverages the plan provides. Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... Sep 26, 2022 · Summary of Benefits 2023 UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H5253-116-000 Look inside to take advantage of the health services and drug coverages the plan provides. Oak Street Health Gate City accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Greensboro, North Carolina locations accept Part B plans, though some require both Part A and Part B. Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Plan 2 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $28.00 (see Plan Premium Details below) Annual Deductible: $0. Annual Initial Coverage Limit (ICL): Y0066_ANOC_H5253_041_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ... 2022 UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H5253-041-0 in NC Plan Benefits Details Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 plan for North Carolina. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. Oct 1, 2022 · Wellcare by Health Net for California Post Office Box 10420 Van Nuys, CA 91410 From October 1 – March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M Oct 1, 2022 · Wellcare by Health Net for California Post Office Box 10420 Van Nuys, CA 91410 From October 1 – March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. H5253-041: Download: AARP Medicare Advantage Walgreens (HMO-POS) 2023: H5253-110: Download: UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) 2023: R1548-001: Download: AARP Medicare Advantage Plan 3 (HMO-POS) 2023: H5253-117: UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) 2023: H5253-116: UnitedHealthcare Dual Complete Choice (PPO ... Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... H5253-041: Download: AARP Medicare Advantage Walgreens (HMO-POS) 2023: H5253-110: Download: UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) 2023: R1548-001: Download: AARP Medicare Advantage Plan 3 (HMO-POS) 2023: H5253-117: UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) 2023: H5253-116: UnitedHealthcare Dual Complete Choice (PPO ... o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 AARP Medicare Advantage Plan 2 (HMO-POS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $20.00. Prior Authorization Required for Chiropractic Services. Original Medicare. Oak Street Health High Point accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our High Point, North Carolina locations accept Part B plans, though some require both Part ... o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 plans for North Carolina and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. Y0066_ANOC_H5253_041_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Sep 26, 2022 · AARP® Medicare Advantage Plan 2 (HMO-POS) dummy spacing Benefits In-Network Inpatient Hospital Care2 $250 copay per day: days 1-5 $0 copay per day: days 6 and beyond Our plan covers an unlimited number of days for an Original Medicare. Oak Street Health High Point accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our High Point, North Carolina locations accept Part B plans, though some require both Part ... 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 AARP Medicare Advantage Plan 1 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $27.00 (see Plan Premium Details below) Annual Deductible: $0. 2020 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Guilford, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M 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. H5253-041: Download: AARP Medicare Advantage Walgreens (HMO-POS) 2023: H5253-110: Download: UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) 2023: R1548-001: Download: AARP Medicare Advantage Plan 3 (HMO-POS) 2023: H5253-117: UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) 2023: H5253-116: UnitedHealthcare Dual Complete Choice (PPO ... The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 2,168 members enrolled in this plan in Buncombe, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 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. Comprehensive Dental: Copayment for Medicare-covered Benefits $0.00. Copayment for Non-routine Services $0.00. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Number 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 ...

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 ... . Stonk o

h5253 041

2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Durham, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Durham, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 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. AARP Medicare Advantage Plan 2 (HMO-POS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $20.00. Prior Authorization Required for Chiropractic Services. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M Oak Street Health Gate City accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Greensboro, North Carolina locations accept Part B plans, though some require both Part A and Part B. The average monthly premium for Medicare Advantage plans in Wake is $9.46 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Wake County have an average Medicare Star Rating of 3.90 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare plans. Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $20.00. Prior Authorization Required for Doctor Specialty Visit. Inpatient hospital care. In-Network: Acute Hospital Services: $295.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Mecklenburg, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Jan 1, 2023 · Summary of Benefits 2023 AARP® Medicare Advantage Plan 1 (HMO-POS) H5253-111-001 Look inside to take advantage of the health services and drug coverages the plan provides. 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. Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Catawba, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. .

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