UHC Complete Care WI-0003 (PPO C-SNP) H0294-010-000 2024 Plan Details and Costs (2024)

UHC Complete Care WI-0003 (PPO C-SNP) is a PPO C-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare

Plan ID: H0294-010-000

$18.00 Monthly Premium

Wisconsin Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Wisconsin Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

Coverage Details
Monthly plan premium$18.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$5,500.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visit
Out-of-Network:

Doctor Office Visit:
Copayment for Medicare Covered Primary Care Office Visit $0.00

Specialty doctor visitIn-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $0.00 to $45.00
Prior Authorization Required for Doctor Specialty Visit

Inpatient hospital careIn-Network:

Acute Hospital Services:
$350.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
Prior Authorization Required for Acute Hospital Services

Urgent care
Urgent Care:
Copayment for Urgent Care $0.00 to $40.00

Benefit Details - General 4b Note - NOTE ON COST SHARING RANGE FOR URGENTLY NEEDED SERVICES: $0 copayment applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services.

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0.00

Emergency room visit
Emergency Care:
Copayment for Emergency Care $120.00
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $0.00
Copayment for Worldwide Emergency Transportation $0.00

Ambulance transportation
Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $290.00
Copayment for Medicare Covered Ambulance Services - Air $290.00

Health Care Services and Medical Supplies

UHC Complete Care WI-0003 (PPO C-SNP) covers a range of additional benefits. Learn more about UHC Complete Care WI-0003 (PPO C-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

Coverage Details
Chiropractic servicesIn-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15.00
Prior Authorization Required for Chiropractic Services

Diabetes supplies, training, nutrition therapy and monitoringIn-Network:

Diabetic Supplies and Services:
Copayment for Medicare-covered Diabetic Supplies $0.00
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $0.00
Prior Authorization Required for Diabetic Supplies and Services
Diabetic Supplies and Services limited to those from specified manufacturers(Please see Evidence of Coverage)

Durable medical equipment (DME)In-Network:

Durable Medical Equipment:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Prior Authorization Required for Durable Medical Equipment

Diagnostic tests, lab and radiology services, and X-rays
Out-of-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare Covered Diagnostic Procedures/Tests $50.00
Copayment for Medicare Covered Lab Services $0.00
Copayment for Medicare Covered Diagnostic Radiological Services $0.00 to $250.00
Copayment for Medicare Covered Therapeutic Radiological Services $60.00
Copayment for Medicare Covered Outpatient X-Ray Services $25.00

Home health careIn-Network:

Home Health Services:
Copayment for Medicare-covered Home Health Services $0.00
Prior Authorization Required for Home Health Services

Mental health inpatient care
Out-of-Network:
$350.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
Mental health outpatient care
Out-of-Network:

Outpatient Mental Health Services:
Copayment for Medicare Covered Individual Sessions $10.00 to $15.00
Copayment for Medicare Covered Group Sessions $10.00 to $15.00

Outpatient services/surgery
Out-of-Network:

Outpatient Hospital and ASC Services:
Copayment for Medicare Covered Outpatient Hospital Services $0.00 to $350.00
Copayment for Medicare Covered Ambulatory Surgical Center Services $0.00 to $350.00

Outpatient substance abuse careIn-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $0.00 to $15.00
Copayment for Medicare-covered Group Sessions $10.00
Prior Authorization Required for Outpatient Substance Abuse Services

Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $0.00
Copayment for Routine Foot Care $0.00

  • Maximum 6 visits every year
Prior Authorization Required for Podiatry Services
Skilled Nursing Facility (SNF) care
Out-of-Network:
$0.00 per day for days 1 to 20
$203.00 per day for days 21 to 100

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Dental care
Out-of-Network:

Medicare Covered Dental Services:
Coinsurance for Medicare Covered Comprehensive Dental 20%
Non-Medicare Covered Dental Services:
Copayment for Non-Medicare Covered Preventive Dental $0.00
Coinsurance for Non-Medicare Covered Comprehensive Dental 0% to 50%

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Vision benefits
Out-of-Network:

Medicare Covered Vision Services:
Copayment for Medicare Covered Eye Exams $0.00
Copayment for Medicare Covered Eyewear $0.00
Non-Medicare Covered Vision Services:
Copayment for Non-Medicare Covered Eye Exams $0.00
Copayment for Non-Medicare Covered Eyewear $0.00

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Hearing benefits
Out-of-Network:

Medicare Covered Hearing Services:
Copayment for Medicare Covered Hearing Exams $45.00
Non-Medicare Covered Hearing Services:
Copayment for Non-Medicare Covered Hearing Exams $45.00
Copayment for Non-Medicare Covered Hearing Aids $99.00 to $1249.00

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Preventive services and health/wellness education programs
Out-of-Network:

Medicare-covered Zero Dollar Preventive Services:
Copayment for Medicare Covered Medicare-covered Preventive Services $0.00

When reviewing Wisconsin Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Wisconsin that offer similar benefits at similar or lower prices than the plan above. Call 1-855-580-1854 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents
  • Summary of benefits
  • Evidence of coverage
  • Star ratings

Wisconsin Counties Served

Ashland Barron Bayfield Buffalo Burnett Chippewa Clark Crawford Douglas Dunn Eau Claire Gogebic Iron Juneau La Crosse Lincoln Marathon Monroe Oneida Pepin Pierce Polk Portage Price Richland Rusk Saint Croix Sawyer Taylor Trempealeau Vernon Vilas Washburn Wood

We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

Back to plans in Wisconsin

UHC Complete Care WI-0003 (PPO C-SNP) H0294-010-000 2024 Plan Details and Costs (2024)

FAQs

Why are people leaving Medicare Advantage plans? ›

Tens of thousands of Medicare Advantage beneficiaries in California, for instance, had to scramble to switch their insurance or their providers when health care system Scripps Health announced that two of its medical groups would no longer take Medicare Advantage in 2024.

What is the disadvantage of UnitedHealthcare? ›

Medicare Advantage monthly costs

AARP/UnitedHealthcare is a poor choice for PFFS plans. PFFS plans aren't a popular choice since they are usually expensive and can limit your choice of doctors. For these plans, UnitedHealthcare has high prices, low ratings and limited availability.

Is UnitedHealthcare Dual Complete the same as Medicare Advantage? ›

You'll keep your Medicaid plan, and you'll still get all the same Medicaid benefits you get now. A dual health plan is a type of Medicare Advantage plan. It will replace your current Medicare plan. Plus, it includes prescription drug coverage and many other benefits and features you don't get with Original Medicare.

Why are Medicare Advantage plans bad? ›

Restrictive networks

Medicare Advantage plans, however, have provider networks. In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network.

Why do hospitals not like Medicare Advantage plans? ›

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.

Do Advantage plans replace Medicare? ›

If you join a Medicare Advantage Plan you'll still have Medicare, but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You'll have the same rights and protections you would have under Original Medicare.

Why are people against UHC? ›

Arguments related to America UHC is fundamentally anti-American, because America is a capitalist and individualist society. It is anti-American to perpetuate a system that hurts innocent, hardworking Americans and that puts America at a tremendous economic disadvantage relative to other countries.

What is the most popular medicare advantage plan for 2024? ›

Humana has the best Medicare Advantage plans for 2024 because of its high-quality ratings, good customer satisfaction, many $0-per-month plans and its widespread availability. You can buy a Humana Medicare Advantage plan in every state but Alaska. Humana's Medicare Advantage plans offer high levels of quality care.

What is negative about advantage plans? ›

There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling. Whether you choose original Medicare or Medicare Advantage, it's important to review healthcare needs and Medicare options before choosing your coverage.

What is a SNP in Medicare? ›

A Special Needs Plan (SNP) provides benefits and services to people with specific conditions, certain health care needs, or who also have. Medicaid. Medicaid. A joint federal and state program that helps with medical costs for some people with limited income and resources.

Can you have Medicare and UnitedHealthcare at the same time? ›

UnitedHealthcare Dual Complete plans

This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

What does d snp mean? ›

Dual Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal, and offer care coordination and wrap-around services.

What is the controversy with United Healthcare? ›

All of the lawsuits claim that Change failed to safeguard patients' personal information, putting them at risk of identity theft and privacy violations. Some also allege that patients have been unable to fill prescriptions because their insurance claims cannot be processed, putting their health at risk.

What is the biggest problem with Medicare? ›

The biggest challenges reported by those in Traditional Medicare and Medicare Advantage: Out-of-pocket medical costs and health services they needed but weren't covered. “The gaps in Medicare coverage can really be notable,” says Jacobson.

What is the downside to Medigap plans? ›

The downside of high-deductible Plan G can, of course, be your upfront cost before you receive help with out-of-pocket expenses. Assuming you have this high-deductible Medigap plan and receive a Medicare Part B-covered service, you'll be responsible for the Part B deductible, which is $240 in 2024.

Why are advantage plans being pushed? ›

Brokers have a financial incentive to encourage enrollment in Medicare Advantage plans because commissions are higher for Medicare Advantage than for Medigap and Part D plans that are purchased to complement traditional Medicare.

Can I drop my Medicare Advantage plan and go back to original Medicare? ›

If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare Part A & Part B.

What are people saying about Medicare Advantage plans? ›

Patients reported similar rates of satisfaction with each plan. Advantage outperformed on measures such as preventive services, whereas traditional Medicare outperformed on measures such as receiving care in the highest-rated hospitals for cancer care.

Are seniors happy with Medicare Advantage plans? ›

According to a new survey released today from the Commonwealth Fund, 96% of Medicare Advantage (MA) members and 93% of enrollees in traditional Medicare said that their Medicare coverage met their expectations, including 65% of each group who said their coverage fully met their expectations.

References

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