On this page we help consumers: Compare UnitedHealthcare Nursing Home Plan 1 with other Medicare Special Needs Plans available in Herkimer County, New York. This is a Local PPO plan for Institutional beneficiaries, that includes prescriptions (Part D), with a $36.60/mo premium.
What is UnitedHealthcare Nursing Home Plan 1 (Local PPO I-SNP)?
UnitedHealthcare Nursing Home Plan 1 is a 2020 I-SNP Medicare Special Needs Plan, from UnitedHealthcare, available in Herkimer County, New York.
- It's a Local PPO health plan for people living in a nursing home or who require skilled nursing care at home.
- It includes prescription drug coverage (Medicare Part D).
- It offers the same health insurance benefits as Original Medicare.
- It offers extras that Medicare does not cover.
- Most of the costs of joining this Medicare Special Needs Plan will be covered for you.
How to Qualify to Enroll in UnitedHealthcare Nursing Home Plan 1
If you qualify and enroll, this Local PPO plan replaces your Original Medicare coverage. To qualify, you must meet the following criteria:
- You have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
- You live in the plan's service area.
- You live in an institution (like a nursing home), or you require nursing care at home.
IMPORTANT: If you qualify for this plan based on your institutional status, but you also qualify for Medicaid, be sure to ask if the plan coordinates your Medicaid services.
If you don't qualify to join an SNP plan like this one, you can compare Herkimer County, NY Medicare Advantage plans. Another potential option to explore is a New York supplemental Medicare plan and a stand-alone Medicare Part D plan in New York.
Before Joining UnitedHealthcare Nursing Home Plan 1, Consider These Questions:
- Does the plan's network include my nursing home or home care provider?
- What costs should I expect for my coverage (premiums, deductibles, copayments)?
- Is there an annual limit on my out-of-pocket expenses?
- Will I be able to use my doctors? Are they in the plan's network?
- Are the plan's in-network providers and facilities in convenient locations?
- Does the plan provide coverage for services I receive from out-of-network providers?
- Do I need a referral to see a specialist?
- Are my medications on the plan's formulary?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
How Much Does UnitedHealthcare Nursing Home Plan 1 Cost?
The premium on this plan is $36.60 per month. That includes your prescription drugs, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H2292-001 Summary of Benefits below).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $435.00 per year. That means you pay 100% of your prescription costs until you've spent $435.00, then the plan will begin paying it's share.
UnitedHealthcare Nursing Home Plan 1 is a new plan for 2020. As such it has not been rated by CMS.
NOTE: Many new plans enter the market with low premiums and low co-pays. Remember, it's important to evaluate plans every year. This is particularly true with new plans.
UnitedHealthcare Nursing Home Plan 1 Medicare Part D Co-Pays
This SNP plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
How Much are the Copays & Co-Insurance?
Co-pay data coming soon. For assistance call: 1-855-266-4865.
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. 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 or the Wikipedia page. To learn more about this plan, visit the UnitedHealthcare Medicare website.
Medicare Part C Plan Availability
UnitedHealthcare Nursing Home Plan 1 is available to beneficiaries living in Cold Brook, Dolgeville, Eagle Bay, Frankfort, Herkimer, Ilion, Jordanville, Little Falls, Middleville, Mohawk, Newport, Old Forge, Poland, Salisbury Center, Thendara, Van Hornesville, West Winfield, and all other areas of Herkimer County, New York; Medicare plans are the same throughout the County.