UnitedHealthcare Medicare Advantage Patriot (HMO-POS) New Haven County, Connecticut Medicare Advantage Plan
UnitedHealthcare Medicare Advantage Patriot, by UnitedHealthcare, is a 2023 Medicare Advantage HMO-POS plan for Medicare beneficiaries living in New Haven County, Connecticut. Delivery of healthcare services and costs are different than in Original Medicare, but the plan may offer additional benefits.
Key Takeaways
- UnitedHealthcare Medicare Advantage Patriot is an HMO-POS Medicare Advantage plan.
- The Point-of-Service (POS) option allows members to use healthcare providers outside of the plan's network (rules and limitations apply) with an additional point-of-service charge.
- It provides all the same benefits as Original Medicare, but your costs will be different (see "Health Plan Costs & Benefits" below).
- It may offer extra benefits that Original Medicare does not cover.
- The monthly premium in New Haven County is $0.00.
- The plan's monthly premium does not replace your Medicare Part B premium.
- This plan offers a Medicare Part B giveback benefit (Part B premium reduction) of $30.00 per month.
- The health plan does not have an annual deductible.
- The maximum out-of-pocket cost with this plan is $6,000 (in-network).
- The annual out-of-pocket limit does not include premiums or prescription costs.
- This UnitedHealthcare plan does not include a Part D prescription drug plan.
- It offers the following supplemental benefits: Dental, Vision, Hearing (limitations apply, see below).
| Plan Basics | |
|---|---|
| Plan ID: | H0755-032-0 |
| Plan Type: | Local HMO |
| Plan Year: | 2023 |
| Premium: | $0.00/mo Plus your Part B premium. |
| Health Plan Deductible: | $0.00 |
| Out-of-Pocket Maximum: | $6,000/yr |
| Part B Reduction: | $30.00/mo |
| Drug Plan Benefit: | Not Included |
| Rx Gap Coverage: | No |
| Supplemental Benefits: | Dental, Vision, Hearing |
| Availability: | New Haven County, CT |
| Insured By: | UnitedHealthcare |
WARNING: It is not uncommon for a private health plan, like UnitedHealthcare Medicare Advantage Patriot, to have higher hospitalization costs than Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.. For this reason, it is important to carefully consider your personal needs before you enroll. Our free Summary of Benefits PDF download will help you compare this plan.
Health Plan Costs & Benefits
PremiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. , deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., and copays vary widely from plan to plan. It is very important to compare costs and apply them to your personal financial and healthcare needs.
Monthly Premium
UnitedHealthcare Medicare Advantage Patriot's total monthly premium in New Haven County is $0.00. This includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premiumThe Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above....
Some Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). include a monthly Part B premium reduction, also known as the Medicare give back. This plan's Part B premium reduction is $30.00. The monthly premium does not include the plan's supplemental premium for add-on benefits (if available).
Annual Deductible
UnitedHealthcare Medicare Advantage Patriot's deductible is $0.00. Although most Medicare Advantage plans do not have an annual deductible some do. Plans are allowed to choose the amount of the deductible and the services included in the deductible.
Maximum Out-of-Pocket Limit
The Maximum Out-of-Pocket (MOOP) with this UnitedHealthcare plan is $6,000. Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket (MOOP) limit on inpatient and outpatient healthcare services. Once you reach this amount of spending on your copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service., all of your Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B services will be covered at no additional charge for the remainder of the year. MOOP does not include monthly premiums, prescriptions, or other extra benefits.
Health Plan Out-of-Pocket Costs
The following table is a summary of the most common out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. you will incur if you join this UnitedHealthcare plan:
| Healthcare Service | Member Cost |
|---|---|
| Health plan deductible | $0 |
| Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) | $6,000 In-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... |
| Doctor Visits | |
| Primary (In-Network) | $0 copay |
| Wellness programs (e.g., fitness, nursing hotline) | Covered |
| Preventive care | $0 copay |
| Mental Health Services | |
| Inpatient hospital - psychiatric (In-Network) | $395 per day for days 1 through 4 $0 per day for days 5 through 90 (authorization required) |
| Outpatient individual therapy visit with a psychiatrist (In-Network) | $25 copay (authorization required) |
| Outpatient individual therapy visit (In-Network) | $25 copay (authorization required) |
| Outpatient group therapy visit (In-Network) | $15 copay (authorization required) |
| Inpatient hospital - psychiatric (Out-of-Net) | Not Applicable (authorization required) |
| Rehabilitation Services | |
| Physical therapy and speech and language therapy visit (In-Network) | $20 copay (authorization required) |
| Medical Equipment / Supplies | |
| Prosthetics (e.g., braces, artificial limbs) (In-Network) | 20% coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. per item (authorization required) |
| Diabetes supplies (In-Network) | $0 copay per item (authorization required) |
| Diagnostic Procedures / Lab Services / Imaging | |
| Outpatient x-rays (In-Network) | $15 copay (authorization required) |
| Lab services (In-Network) | $0 copay (authorization required) |
| Diagnostic radiology services (e.g., MRI) (In-Network) | $0-140 copay (authorization required) |
| Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. Drugs | |
| Chemotherapy (In-Network) | 20% coinsurance (authorization required) |
| Foot Care (podiatry Services) | |
| Routine foot care (In-Network) | $35 copay (authorization required, limits may apply) |
| Hearing | |
| Hearing aids (In-Network) | $175-1,225 copay (authorization required, limits may apply) |
| Fitting/evaluation | Not covered |
| Preventive Dental | |
| Dental x-ray(s) (In-Network) | $0 copay (limits may apply) |
| Oral exam (Out-of-Net) | $0 copay (limits may apply) |
| Fluoride treatment (In-Network) | $0 copay (limits may apply) |
| Oral exam (In-Network) | $0 copay (limits may apply) |
| Fluoride treatment (Out-of-Net) | $0 copay (limits may apply) |
| Cleaning (Out-of-Net) | $0 copay (limits may apply) |
| Cleaning (In-Network) | $0 copay (limits may apply) |
| Comprehensive Dental | |
| Periodontics | Not covered |
| Restorative services | Not covered |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
| Extractions | Not covered |
| Endodontics | Not covered |
| Diagnostic services | Not covered |
| Vision | |
| Eyeglasses (frames and lenses) (In-Network) | $0 copay (limits may apply) |
| Other | Not covered |
| Eyeglass lenses | Not covered |
| Eyeglass frames | Not covered |
| Contact lenses (In-Network) | $0 copay (limits may apply) |
| Upgrades | Not covered |
| Emergency Care / Urgent Care | |
| Emergency | $90 copay per visit (always covered) |
| Ground ambulance | $250 copay |
| Inpatient hospital coverage | $395 per day for days 1 through 4 $0 per day for days 5 through 90 $0 per day for days 91 and beyond |
| Outpatient hospital coverage | $0-250 copay per visit |
| Skilled Nursing Facility | Not Applicable |
| Optional supplemental benefits | Yes |
Feel free to download our UnitedHealthcare Medicare Advantage Patriot Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS Rating Marks and Our Review
It's not a 5-star HMO-POS plan, but its quality of care exceeds most Medicare Advantage HMO-POS plans in the areas served (see list below). Staying healthy is the best way to save money on health care, and UnitedHealthcare Medicare Advantage Patriot does a good job keeping its members in top health through preventive care, including screenings, tests, and vaccines. This plan is good at managing its member's chronic (long-term) health conditions. The member experience with this UnitedHealthcare plan is average. Complaints and changes in plan performance are one way we can measure quality, and this plan scores good at both. The plan shines at customer service with an overall excellent mark on this important metric.
Beneficiaries searching for top value will find dental, vision, and hearing benefits available with this Medicare Advantage plan (limitations apply). With no additional monthly premium, this plan can save you money if you're healthy. If you're looking for all the savings you can get, this Local HMO plan has a Part B reduction benefit, often called a giveback, of $30.00 per month. With a maximum out-of-pocket limit of $6,000 per year, this plan could be costly if you have chronic health conditions. In the event of a 5-day hospital stay, costs will likely be higher than Original Medicare. With no annual deductible, members of this health plan have first dollar coverage, which is comforting on a fixed budget.
The following table shows the quality ratings for this UnitedHealthcare plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each...) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0:
| CMS Measure | Star Rating |
|---|---|
| 2023 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Additional HMO-POS Medicare Advantage Plan Options
Here are some additional Medicare Advantage plans in New Haven County (HMO-POSs) that might be worth reviewing:
- Aetna Medicare Value Plan
- ConnectiCare Flex Plan 2
- ConnectiCare Flex Plan 3
- ConnectiCare Flex Plan 1
- UnitedHealthcare Medicare Advantage Plan 3
Contact UnitedHealthcare
| Plan Website: | http://www.UHCMedicareSolutions.com |
|---|---|
| Formulay Information: | http://www.UHCMedicareSolutions.com |
| Pharmacy Information: | UnitedHealthcare Pharmacy Page |
| Prospective Members: | (800)555-5757 |
| TTY Users: | (711)- |
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Citations & References
- UnitedHealthcare, http://www.UHCMedicareSolutions.com, Last Accessed October 15, 2022
- Medicare.gov, "Types of Medicare Advantage Plans", Last Accessed January 21, 2023
- Medicare.gov, "Your Medicare Choices", Last Accessed January 4, 2023
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed November 1, 2022
- Medicare.gov, "What Medicare Covers", Last Accessed August 7, 2022
- CMS.gov, Landscape Source Files, Last Accessed January 26, 2023
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 26, 2023
- CMS.gov, Plan Benefits Package, Last Accessed January 26, 2023
The Medicare Advantage plan information on this page was last updated on .