2024 UHC Complete Care CA-06AP C-SNP: H0543-246-0 by UnitedHealthcare
What is Plan H0543-246-0 by UnitedHealthcare?
UHC Complete Care CA-06AP is a C-SNP Medicare Advantage plan, by UnitedHealthcare, for 2024. It has a HMO provider network. This UnitedHealthcare HMO plan is required to provide all of the same benefits as Original Medicare, and includes some additional benefits, but out-of-pocket costs may be different.
You must meet all qualification requirements to join this C-SNP plan.
Plan Basics | |
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Plan ID: | H0543-246-0 |
Plan Type: | HMO |
Plan Year: | 2024 |
Premium: | $24.10/mo Plus your Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Basic $545.00 deductible |
Rx Gap Coverage: | {gap} |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | UnitedHealthcare |
Summary of Benefits |
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Health Plan Costs & Benefits
UHC Complete Care CA-06AP is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, UHC Complete Care CA-06AP does allow out-of-network care for emergencies and out-of-area dialysis.
The following table is a summary of the most common out-of-pocket costs you will incur if you join this UnitedHealthcare plan:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | 20% Coinsurance |
Specialist: | 20% Coinsurance Authorization Required, Referral Required |
Wellness programs (e.g., fitness, nursing hotline): | |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $0 Copay Authorization Required, Referral Required |
Routine foot care: | $0 Copay Authorization Required, Referral Required |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | 20% Coinsurance Authorization Required, Referral Required |
Routine chiropractic care: | $0 |
Emergency Care / Urgent Care | |
Emergency room care: | $100 Copay |
Urgent care: | $40 Copay |
Ground ambulance: | 20% Coinsurance |
Inpatient hospital coverage: | $1,480.00 per stay |
Outpatient hospital coverage: | 20% Coinsurance Authorization Required, Referral Required |
Skilled Nursing Facility: | |
Optional supplemental benefits: | Not Covered |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | 20% Coinsurance |
Outpatient group therapy visit with a psychiatrist: | 20% Coinsurance |
Inpatient hospital - psychiatric: | $1,480.00 per stay |
Outpatient group therapy visit: | 20% Coinsurance |
Outpatient individual therapy visit: | 20% Coinsurance Authorization Required, Referral Required |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | 20% Coinsurance Authorization Required, Referral Required |
Occupational therapy visit: | 20% Coinsurance Authorization Required, Referral Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 Copay Authorization Required |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | 20% Coinsurance Authorization Required, Referral Required |
Lab services: | $0 Copay Authorization Required, Referral Required |
Outpatient x-rays: | 20% Coinsurance Authorization Required, Referral Required |
Diagnostic tests and procedures: | $0 Copay Authorization Required, Referral Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our UHC Complete Care CA-06AP Summary of Benefits information.
Supplemental Health Plan Benefits (H0543-246-0)
The following is a summary of the supplemental benefits UnitedHealthcare includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | Not Covered |
Vision | Maximum vision benefit: | $300.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay Authorization Required, Referral Required |
Contact lenses (In-Network) | $0 Copay |
Additional Supplemental Benefits
None specified.
Prescription Drug Plan Costs & Benefits
UHC Complete Care CA-06AP includes an basic benefit Medicare Part D plan (PDP). This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid Services, whereas enhanced benefit plans cover more.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $24.10 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $24.10 |
Part D Premium with Full LIS Assistance: | $0.00 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $545.00. This is the amount you must pay at the pharmacy before UnitedHealthcare begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, UHC Complete Care CA-06AP has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
Drug Tier | Preferred | Standard |
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$0 copay on all covered generic and brand-name prescriptions. |
CMS 5-Star Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage C-SNP's in nine broad categories using a 5-star rating system. Medicare's star ratings will help you understand the quality of care and service you can expect if you join this UnitedHealthcare plan.
CMS Measure | Star Rating |
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2024 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 |
How to Qualify to Enroll in
UHC Complete Care CA-06AP
To be eligible to enroll in UHC Complete Care CA-06AP, you must meet these requirements:
- You are eligible for Medicare;
- You live in County (the plan’s service area); and
- You have been diagnosed with one or more severe or disabling chronic conditions.
A disabiling chronic condition (disease) is one that lasts one or more years and requires ongoing medical attention and/or limits activities of daily living. They include:
- Autoimmune disorders
- End-stage renal disease
- Cancer
- Cardiovascular disorders
- Hematologic disorders
- HIV/AIDS
- Chronic heart failure
- Chronic lung disorders
- Neurologic disorders
- Dementia
- Diabetes
- End-stage liver disease
- Neurologic disorders
- Stroke
- Mental health conditions
This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes.
Plan Availability
UHC Complete Care CA-06AP (H0543-246-0) is available in the following locations (click to open):
Additional C-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
- H0543-227-0: UHC Complete Care CA-028P (C-SNP)
- H0543-218-0: UHC Complete Care CA-019P (C-SNP)
- H0543-247-0: UHC Complete Care CA-07AP (C-SNP)
- H0543-239-0: UHC Complete Care CA-01AP (C-SNP)
- H0543-242-0: UHC Complete Care CA-04AP (C-SNP)
Contact UnitedHealthcare
Plan Website: | http://AARPMedicarePlans.com |
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Formulay Information: | http://AARPMedicarePlans.com |
Pharmacy Information: | UnitedHealthcare Pharmacy Page |
Prospective Members: | (800)555-5757 |
TTY Users: | 711 |
If you qualify for Medicare benefits 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.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- UnitedHealthcare, http://AARPMedicarePlans.com, Last Accessed October 13, 2023
- Medicaid.gov, "Medicaid & CHIP in ", Last Accessed January 4, 2024
- CMS.gov, "Chronic Condition Special Needs Plans (C-SNPs)", Last Accessed January 20, 2023
- CMS.gov, Landscape Source Files, Last Accessed January 2, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 2, 2024
- CMS.gov, Plan Benefits Package, Last Accessed January 3, 2024