Go Back

UnitedHealthcare Medicare Silver (Regional PPO C-SNP)

R6801 - 008 - 0
4 out of 5 stars (4 / 5)

UnitedHealthcare Medicare Silver (Regional PPO C-SNP) is a Medicare Advantage (Part C) Special Needs Plan by UnitedHealthcare.

This page features plan details for 2023 UnitedHealthcare Medicare Silver (Regional PPO C-SNP) R6801 – 008 – 0 available in Texas.

IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link below:
2024 UHC Complete Care TX-001A (Regional PPO C-SNP) R6801 - 008 - 0

Locations

UnitedHealthcare Medicare Silver (Regional PPO C-SNP) is offered in the following locations.

Anderson County, Texas
Andrews County, Texas
Angelina County, Texas

Click to see more locations

Plan Overview

UnitedHealthcare Medicare Silver (Regional PPO C-SNP) offers the following coverage and cost-sharing.

Special Needs Plan Type:Chronic or Disabling Condition
Conditions Covered:
  • Cardiovascular Disorders, Chronic Heart Failure and Diabetes
    • Insurer:UnitedHealthcare
    Health Plan Deductible:$233 annual deductible
    MOOP:$8,300 In and Out-of-network
    $8,300 In-network
    Drugs Covered:Yes

    Ready to sign up for UnitedHealthcare Medicare Silver (Regional PPO C-SNP) ?

    Get help from a licensed insurance agent.

    Call 1-877-354-4611 TTY 711.

    8am – 11pm EST. 7 days a week

    Premium Breakdown

    UnitedHealthcare Medicare Silver (Regional PPO C-SNP) has a monthly premium of $8.90. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
    Part B Part C Part D Part B Give Back Total
    $164.90 $0.00 $8.90 $0.00 $173.80
    Please Note:
    • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
    • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

    Drug Info

    UnitedHealthcare Medicare Silver (Regional PPO C-SNP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

    Drug Deductible: $505.00
    Initial Coverage Limit: $4,660.00
    Catastrophic Coverage Limit: $7,400.00
    Drug Benefit Type: Basic
    Gap Coverage: No
    Formulary Link: Formulary Link

    Part D Premium Reduction

    The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs. The table below shows how the LIS impacts the Part D premium of this plan.
    Part D LIS 25% LIS 50% LIS 75% LIS Full
    $8.90 $43.40 $34.80 $26.30 $17.70

    Initial Coverage Phase

    After you pay your $505.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.

    Gap Coverage Phase

    After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.

    Drug TypeCost Share
    Generic drugs25%
    Brand-name drugs25%

    Catastrophic Coverage Phase

    After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

    Drug TypeCost Share
    Generic drugs$4.15 copay or 5% (whichever costs more)
    Brand-name drugs$10.35 copay or 5% (whichever costs more)

    Additional Benefits

    UnitedHealthcare Medicare Silver (Regional PPO C-SNP) also provides the following benefits.

    Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    In-Network: No

    Dental (comprehensive)

    Diagnostic services:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Diagnostic services:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Endodontics:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Endodontics:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Extractions:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Extractions:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Non-routine services:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Non-routine services:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Periodontics:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Periodontics:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Prosthodontics, other oral/maxillofacial surgery, other services:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Prosthodontics, other oral/maxillofacial surgery, other services:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Restorative services:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Restorative services:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)

    Dental (preventive)

    Cleaning:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Cleaning:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Dental x-ray(s):In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Dental x-ray(s):Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Fluoride treatment:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Fluoride treatment:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Oral exam:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Oral exam:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)

    Diagnostic procedures/lab services/imaging

    Diagnostic radiology services (e.g., MRI):In-Network: 0-20% coinsurance (authorization required) (referral not required)
    Diagnostic radiology services (e.g., MRI):Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Diagnostic tests and procedures:In-Network: 20% coinsurance (authorization required) (referral not required)
    Diagnostic tests and procedures:Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Lab services:In-Network: $0 copay (authorization required) (referral not required)
    Lab services:Out-of-Network: $0 copay (authorization required) (referral not required)
    Outpatient x-rays:In-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient x-rays:Out-of-Network: 20% coinsurance (authorization required) (referral not required)

    Doctor visits

    Primary:In-Network: 20% coinsurance per visit
    Primary:Out-of-Network: 20% coinsurance per visit
    Specialist:In-Network: 20% coinsurance per visit (authorization required) (referral not required)
    Specialist:Out-of-Network: 20% coinsurance per visit (authorization required) (referral not required)

    Emergency care/Urgent care

    Emergency: $90 copay per visit (always covered)
    Urgent care: $40 copay per visit (always covered)

    Foot care (podiatry services)

    Foot exams and treatment:In-Network: $0 copay (authorization required) (referral not required)
    Foot exams and treatment:Out-of-Network: $0 copay (authorization required) (referral not required)
    Routine foot care:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Routine foot care:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)

    Ground ambulance

    In-Network: 20% coinsurance
    Out-of-Network: 20% coinsurance

    Health plan deductible

    $233 annual deductible

    Health plan deductibles (other)

    In-Network: No

    Hearing

    Fitting/evaluation: Not covered (no limits)
    Hearing aids:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Hearing aids:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Hearing exam:In-Network: 20% coinsurance (authorization required) (referral not required)
    Hearing exam:Out-of-Network: 20% coinsurance (authorization required) (referral not required)

    Hospital coverage (inpatient)

    In-Network: $1,556 per stay
    $0 per day for days 91 and beyond (authorization required) (referral not required)
    Out-of-Network: $1,556 per stay (authorization required) (referral not required)

    Hospital coverage (outpatient)

    In-Network: 0-20% coinsurance per visit (authorization required) (referral not required)
    Out-of-Network: 20% coinsurance per visit (authorization required) (referral not required)

    Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    $8,300 In and Out-of-network
    $8,300 In-network

    Medical equipment/supplies

    Diabetes supplies:In-Network: $0 copay per item (authorization required)
    Diabetes supplies:Out-of-Network: 30% coinsurance per item (authorization required)
    Durable medical equipment (e.g., wheelchairs, oxygen):In-Network: 20% coinsurance per item (authorization required)
    Durable medical equipment (e.g., wheelchairs, oxygen):Out-of-Network: 20% coinsurance per item (authorization required)
    Prosthetics (e.g., braces, artificial limbs):In-Network: 20% coinsurance per item (authorization required)
    Prosthetics (e.g., braces, artificial limbs):Out-of-Network: 20% coinsurance per item (authorization required)

    Medicare Part B drugs

    Chemotherapy:In-Network: 20% coinsurance (authorization required)
    Chemotherapy:Out-of-Network: 0-20% coinsurance (authorization required)
    Other Part B drugs:In-Network: 0-20% coinsurance (authorization required)
    Other Part B drugs:Out-of-Network: 0-20% coinsurance (authorization required)

    Mental health services

    Inpatient hospital – psychiatric:In-Network: $1,556 per stay (authorization required) (referral not required)
    Inpatient hospital – psychiatric:Out-of-Network: $1,556 per stay (authorization required) (referral not required)
    Outpatient group therapy visit:In-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient group therapy visit:Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient group therapy visit with a psychiatrist:In-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient group therapy visit with a psychiatrist:Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient individual therapy visit:In-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient individual therapy visit:Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient individual therapy visit with a psychiatrist:In-Network: 20% coinsurance (authorization required) (referral not required)
    Outpatient individual therapy visit with a psychiatrist:Out-of-Network: 20% coinsurance (authorization required) (referral not required)

    Optional supplemental benefits

    No

    Preventive care

    In-Network: $0 copay (authorization not required) (referral not required)
    Out-of-Network: $0 copay (authorization not required) (referral not required)

    Rehabilitation services

    Occupational therapy visit:In-Network: 20% coinsurance (authorization required) (referral not required)
    Occupational therapy visit:Out-of-Network: 20% coinsurance (authorization required) (referral not required)
    Physical therapy and speech and language therapy visit:In-Network: 20% coinsurance (authorization required) (referral not required)
    Physical therapy and speech and language therapy visit:Out-of-Network: 20% coinsurance (authorization required) (referral not required)

    Skilled Nursing Facility

    In-Network: In 2023 the amounts for each benefit period are:
    $0 copay for days 1 through 20
    $200 copay per day for days 21 through 100 (authorization required) (referral not required)
    Out-of-Network: 20% per stay (authorization required) (referral not required)

    Transportation

    In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Out-of-Network: 75% coinsurance (limits may apply) (authorization not required) (referral not required)

    Vision

    Contact lenses:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Contact lenses:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Eyeglass frames: Not covered (no limits)
    Eyeglass lenses: Not covered (no limits)
    Eyeglasses (frames and lenses):In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Eyeglasses (frames and lenses):Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
    Other: Not covered (no limits)
    Routine eye exam:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Routine eye exam:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
    Upgrades: Not covered

    Wellness programs (e.g., fitness, nursing hotline)

    Covered (authorization not required) (referral not required)

    Ready to sign up for UnitedHealthcare Medicare Silver (Regional PPO C-SNP) ?

    Get help from a licensed insurance agent.

    Call 1-877-354-4611 TTY 711.

    8am – 11pm EST. 7 days a week

    Table of Contents

    SMID: MULTIPLAN_HCIHNDOGMED01_M

    Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.

    This is a promotional communication.

    Every year, Medicare evaluates plans based on a 5-star rating system.

    Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

    Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

    All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

    We do not offer every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

    HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 52,101 products in your area.

    We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Enrollment is offered through our partners including HealthCompare Insurance Services Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

    HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

    Medicare has neither approved nor endorsed any information on this site.

    © All rights reserved | About | Contact | Legal and Privacy