|Part D Benefit:||Yes|
|Rx Gap Coverage:||No|
|Plan Phone #:||866-231-7201|
|Summary of Benefits:|
UnitedHealthcare The Villages MedicareComplete 1 is a Health Maintenance Organization (HMO) Medicare Advantage plan, by Preferred Care Partners, available in Sumter County, Florida. It offers all of the basic benefits of Original Medicare and may include additional coverage.
With an HMO plan, like this one from Preferred Care Partners, your out-of-pocket costs are much lower than Original Medicare. That's the big advantage.
IMPORTANT: You must use providers in the Preferred Care Partners network to avoid incurring additional costs. You are responsible for all costs incurred out of network. Referrals are generally required to see specialists.
This plan has a zero dollar premium!
If you enroll in the UnitedHealthcare The Villages MedicareComplete 1 plan you will continue to pay your Medicare Part B premium. However, there's no additional monthly premium to be in this plan. Be aware that some people pay a higher Part B premium due to their annual income level (over $85,000 per year for singles or $170,000 for married couples) or due to a late enrollment penalty.
In addition to the premiums you also pay your share when you use healthcare services. Each time you see your doctor, or if you are admitted as an inpatient (hospitalized), you'll pay copayments. Your prescription drugs also have a cost sharing component.
Maximum Out-of-Pocket Limit
2017 Medicare Advantage plans have an annual maximum out-of-pocket (MOOP) limit that protects you from financial disaster. The MOOP limit is $6,700, but plans can go as low as $3,400.
The most you will pay out-of-pocket if you enroll in this plan is $4,500. This amount does not include your monthly premium or the copayments. This is only the amount that you pay out of pocket.
Don't forget to look at the co-payments and co-insurance with Original Medicare (no out-of-pocket limits). If you stay on Original Medicare you'll need a Medicare Supplement to pay the gaps or pay it yourself.
Coverage, Copayments & Coinsurance
The UnitedHealthcare The Villages MedicareComplete 1 plan offers the same basic benefits as Original Medicare. The big difference is copayments and coinsurances. Below you will find (where available) what you will pay for common health care services.
Most plans have copayments when you see your primary care doctor or a specialist. Here's how this plan works:
|Primary Care Doctor:||20% co-insurance|
|Physician Specialist:||$30 co-payment|
|Occupational Therapist:||$30 co-payment|
|Physical Therapist:||$30 co-payment|
|Speech Terapist:||$30 co-payment|
|Psychotherapist:||You pay nothing|
|Psychiatrist:||You pay nothing|
Medicare covers a wide range of preventive care services, including cardiovascular screenings, alcohol misuse screening and counseling, depression screen, and diabetes screening, to name just a few. Here's how this plan covers the following at no cost:
- Abdominal aortic aneurysm screening
- Alcohol misuse counseling
- Bone mass measurement
- Breast cancer screening (mammogram)
- Cardiovascular disease (behavioral therapy)
- Cardiovascular screenings
- Cervical and vaginal cancer screening
- Colorectal cancer screenings
- Depression screening
- Diabetes screenings
- HIV screening
- Medical nutrition therapy services
- Obesity screening and counseling
- Prostate cancer screenings (PSA)
- Sexually transmitted infections screening and counseling
- Tobacco use cessation counseling
- Vaccines including Flu shots Hepatitis B shots Pneumococcal shots
- 'Welcome to Medicare' preventive visit
- Yearly 'Wellness' visit
Urgent Care and Emergency Room
Urgent care and emergency room services are covered under Medicare Part B and have copayment or coinsurance fees. Some Medicare Advantage plans waive these fees if you are admitted as an inpatient within a specified number of days.
|Urgent Care:||$30 to $40 co-payment|
|Emergency Care:||$75 co-payment |
Co-insurance waived if admitted within 24 Hours
If you are admitted to a hospital or clinic for treatment and stay overnight, you are an inpatient. Most plans have tiered costs for inpatient treatment. Here's how this plan covers you:
- Day 1 to 6 you pay $275 per day
- See the Summary of Benefits for additional copayment periods.
Prescription Drug Coverage
UnitedHealthcare The Villages MedicareComplete 1 includes Medicare Part D coverage for your prescription medications. The table below outlines what you will pay (the copayment) at your pharmacy at each tier level.
If you are entitled to Part D assistance, your premium will be adjusted based on your percentage.
The annual Part D deductible is $0.00 (first dollar coverage).
Medicare Plan Rating
Medicare gave the UnitedHealthcare The Villages MedicareComplete 1 plan an average rating of 4.5.0 out of 5 stars. This rating is Above Average, by Medicare's definition.
Medicare evaluates the quality of all Medicare Advantage plans. Plans are rated using a one to five-star scale, with five stars being the highest quality. If a plan is rated less than 2.5 stars, Medicare will not allow new members to enroll.
Compare UnitedHealthcare The Villages MedicareComplete 1 with these top rated plans available in Sumter County:
- Optimum Gold Rewards Plan
- Freedom Medicare Plan Rx
- Freedom Platinum Plan Rx
- Freedom Savings Plan
- UnitedHealthcare The Villages MedicareComplete 2
UnitedHealthcare The Villages MedicareComplete 1 Availability
UnitedHealthcare The Villages MedicareComplete 1 is available in Webster, Bushnell, Coleman, Center Hill, Lake Panasoffkee, Sumterville, The Villages, Wildwood, Oxford, and all other areas of Sumter County.
This page was last updated on 10/25/2016.