Medicare Counseling: Dual Eligible Special Need Plans (D-SNP) Plan – UnitedHealthcare Dual Complete Select - Full Medicaid

UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) (H3794-004) for people with full Medicaid

 For calendar year 2023

Contact information

 Phone:

• 888-834-3721 Non-members
• 800-396-1942 Members
• TTY: 711

 Website: UnitedHealthcare Dual Complete Select website

Eligibility

 Who can get this plan

People with:

• Full benefit Medicaid
• The Qualified Medicare Beneficiary (QMB) tier of the Medicare Savings Program

 Service area

All counties

Star rating

4.5 out of 5 stars

Coverage

 Check if your doctors are in-network: Medical | Find Care (werally.com)

 Check if your prescription drugs are covered: Prescription drug list (optumrx.com)

 Costs

 Doctor visit: No cost

 Hospitalization: No cost*

*While the cost share for all members is technically $1,556, this amount is covered by Wisconsin Medicaid for Full Duals and QMB members. As such, Full Duals and QMB members have $0 financial responsibility.

Skilled nursing facility: No cost

Emergency department: No cost (always covered)

Extra benefits

Details: Coverage details

 Basic dental: $0 copay

 Extra dental: Up to $1,000 for covered dental such as exams, x-rays, cleanings, fillings, crowns, root canals, extractions, and dentures

 Vision: $0 copay for 1 routine eye exam and $250 allowance for eyewear

 Hearing: Routine hearing exam and $1,100 allowance toward brand-name hearing aids or UnitedHealthcare Hearing's brand Relate™

Wellness programs: Renew Active® is a fitness program for body and mind to help stay active, at a gym or from home, at no additional cost. Free Fitbit® device

Other:

• $0 Rx
• $75 a month on a prepaid card for over the counter (OTC) products and covered groceries at many retailers or online for home delivery
• $0 copay for 24 one-way rides to or from non-emergency medical doctor visits or to get prescription medications
• Up to 28 meals for 14 days after an inpatient hospital stay
• Yearly check-ups at home to help stay up-to-date on your health between regular doctor's visits at no cost
• NurseLine
• Personal emergency response system
• UnitedHealthcare At Home

 How to enroll

You can only enroll during a Medicare enrollment period; learn more at Medicare.gov.

Enrollment into this plan will automatically disenroll you from your current Medicare Advantage or Part D plan.

There are multiple ways to enroll:

• Call the plan at 888-834-3721
• Medicare.gov
• 1-800-MEDICARE
• Contact the State Health Insurance Assistance Program (SHIP)