Browse our extensive directory of the best UnitedHealthcare Therapists, UnitedHealthcare Psychologists and UnitedHealthcare Counselors near you. 1) Individual and group therapy with physicians, psychologists or other mental health professionals authorized by the State; see the Medicare Benefits Policy Manual, Chapter 6, §70.1.C – Application of Criteria. Behavioral health programs may help you cope with emotional struggles. Learn what types of services are covered, find a provider or telehealth service and more.
Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year. UnitedHealthcare Senior Care Options (HMO SNP) Plan. Our Drug Cost Estimator lets you see what you can expect to pay for Medicare Part D prescription drugs. Try it now to understand your coverage options.
Plan overview
The UnitedHealthcare Choice Plus 1500 option is a high deductible health plan. Employees who enroll in this plan pay the full cost for all health care services received until the deductible is met. Then, the plan begins sharing costs, and employees pay 10% of the cost of health care services. The UHC Choice Plus 1500 is the only option that allows you to see any doctor or visit any facility that you want, as it offers out-of-network coverage.
Health Savings Account
The UnitedHealthcare Choice Plus 1500 comes with a Health Savings Account. The Health Savings Account is designed to allow participants to receive a triple tax advantage by putting money away to save for future health care expenses. Find out more here.
Where you can go for care
The UHC Choice Plus 1500 option offers out-of-network coverage, as well as a national network of providers and facilities, along with a Preferred Hospital List, which is a list of preferred facilities where you’ll see the most savings You can see any provider in or out of the the UHC Choice network. You can go to any facility in or out of the UHC Choice network, but if you go to a facility on the Preferred Hospital list, you’ll save the most and pay the least. To find a doctor or facility in the UHC Choice Plus network:
- Visit http://welcometouhc.com/swhr
- Scroll down to the Choice Plan 1500 section
- Under the Find a Doctor section, click “Search the network”
To get the most up to date information, please contact UHC customer service at 1-877-698-4754, prompt 2.
What you pay for care
Plan | UHC Choice Plus Plan 1500 | ||
UHC Choice Network Doctors, Preferred Hospitals and Free-standing Facilities1,9 | UHC Choice | Out-of-Network Doctors, Hospitals and Facilities6 | |
Network | National network with preferred hospitals | ||
Deductible | $1,500 individual | $4,000 individual | $5,000 individual |
Medical and Rx Out-of-Pocket Maximum2 | Avc converter free download for pc. $6,750 individual | $18,000 individual | |
HSA | Employees may contribute up to the IRS maximum limit of $3,550 (employee only coverage) or $7,100 (employee + family coverage). The Health Savings Account comes with:
| ||
Office Visits | Full deductible, then 10% | Full deductible, then 50% | |
Maternity Office Visits | Full deductible, then 10% | Full deductible, then 50% | |
Inpatient Hospital Care | Preferred Hospital: Full deductible, then 10% | Full deductible, then 50% | |
Telehealth | Full deductible, then 10% | ||
Emergency Room | Full deductible, then 10% | ||
Urgent Care Center | Full deductible, then 10% | Full deductible, then 50% | |
Outpatient Surgery1 | Full deductible, then 10% | Full deductible, then 50% | Full deductible, then 50% |
Routine Physicals3 | $0 | Not covered | |
Well-Woman/Man Exams (Including Pap Test or PSA Test)3 | $0 | Not covered | |
Well-Child Care | $0 | Not covered | |
Colonoscopy3 | $0 | Not covered | |
Mammography4 | $0 | Not covered | |
Outpatient Diagnostic Lab & X-ray (Excluding MRI, CT, PET Scans)1 | Coconutbattery 3.7.2. Preferred Hospital: Full deductible, then 10% | Full deductible, then 50% | |
MRI, CT & PET Scans1 | Full deductible, then 10% | Full deductible, then 50% | |
Outpatient Therapy5 | Full deductible, then 10% | Full deductible, then 50% | |
1 When your doctor requests tests or services such as lab work, X-rays, MRIs, CT scans, physical therapy or rehabilitation at a free-standing facility that isn’t affiliated with a hospital, you should check to make sure they are in-network, and if you are in a UHC medical plan option check the coinsurance level of that facility on your plan. Services performed at Preferred Hospitals or at a free-standing facility unaffiliated with a hospital are covered at 90% after deductible by the UHC Choice 500 and Choice 1000 plans, while care at non-Preferred hospitals, if you are in the UHC Choice 500 or Choice 1000 plans, is only covered at 30% after the deductible. Check with your insurance carrier to verify whether a facility and/or doctor is covered under your plan and to learn how much your co-insurance would be.
2 Maximum includes deductible, co-insurance, and copays for medical care and prescriptions.
3 Well exams are covered in full if the claims administrator determines the physical is for preventive care. Additional screenings or services will be considered diagnostic services and will be covered after you pay the applicable copay or deductible and coinsurance. At the time of your preventive care visit, if other services are performed that are not preventive services, as determined by the claims administrator, they will not be paid at 100% even if they are submitted as part of a claim for preventive care.
4 One per year is covered. You pay the coinsurance for additional mammograms.
5 Up to a combined total of 60 visits per year are covered for outpatient physical, occupational, and speech therapy. Pulmonary and rehabilitation services are covered up to 20 visits. Up to 36 cardiac rehabilitation visits are covered.
6 Whenever you use an out-of-network provider, you pay for services when you receive them and file a claim for reimbursement of eligible expenses.
7 $1,000 penalty for failure to provide notification.
8 For the purposes of HSA enrollment, employee + family coverage includes: employee + spouse, employee + children or employee + family coverage.
9 If you have a medical condition that requires care at a facility that is not on the Preferred Hospital list, contact UnitedHealthcare PRIOR to receiving care/treatment. If expertise is limited at the facilities on the Preferred Hospital list, meaning you are not able to get treatment at a Preferred Hospital, your benefits may be pre-approved to be paid as though you had used a Preferred Hospital (ie: your benefits may pay at a higher level, lowering your cost for services). However, this only applies if UnitedHealthcare pre-approves the covered services/supplies for the condition to be provided by or arranged by a designated facility/other provider not on the Preferred Hospital list. The pre-approval by UnitedHealthcare must be completed prior to care being received. If you have any questions or issues, please contact Benefits Support at 1-877-698-4754 prompt 9.
What you pay each paycheck
Click here to view your cost per paycheck.
Features of the plan
There are a variety of cool (and some free) features that come with this plan option. You can find a full list of features here.
Tips
Check out these tips that can help you get the care that is right for you while keeping your costs down.
WHO DO I CONTACT WITH QUESTIONS?
- UnitedHealthCare:
- Phone: 1-877-698-4754, prompt 2
- Web: myUHC.com
- Benefits Support
- Speak with a member of the Benefit Support team by calling 1-877-698-4754 prompt 9 or emailing SWHRCINBenefitsSupport@texashealth.org.
Jump to:
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region R5342-001 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by UnitedHealthcare available to residents in New York. This plan includes additional Medicare prescription drug (Part-D) coverage. The UnitedHealthcare Medicare Advantage Choice Plan 1 (Region has a monthly premium of $16.00 and has an in-network Maximum Out-of-Pocket limit of $6,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out of pocket. This can be a extremely nice safety net.
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region is a Regional PPO. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of 'preferred' providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.
UnitedHealthcare works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for UnitedHealthcare Medicare Advantage Choice Plan 1 (Region you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from UnitedHealthcare and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from UnitedHealthcare except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST
2021 UnitedHealthcare Medicare Advantage Plan Costs
| Name: | UnitedHealthcare Medicare Advantage Choice Plan 1 (Region |
|---|---|
| Plan ID: | |
| Provider: | UnitedHealthcare |
| Year: | 2021 |
| Type: | Regional PPO |
| Monthly Premium C+D: | $16.00 |
| Part C Premium: | $0 |
| MOOP: | $6,700 |
| Part D (Drug) Premium: | $16.00 |
| Part D Supplemental Premium | $0 |
| Total Part D Premium: | $16.00 |
| Drug Deductible: | $300.0 |
| Tiers with No Deductible: | 1 |
| Gap Coverage: | No |
| Benchmark: | not below the regional benchmark |
| Type of Medicare Health: | Enhanced Alternative |
| Drug Benefit Type: | Enhanced |
| Similar Plan: | R5342-002 |
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region Part-C Premium
UnitedHealthcare plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
R5342-001 Part-D Deductible and Premium
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region has a monthly drug premium of $16.00 and a $300.0 drug deductible. This UnitedHealthcare plan offers a $16.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by UnitedHealthcare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $16.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
UnitedHealthcare Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This UnitedHealthcare plan does not offer additional coverage through the gap.
Premium Assistance
The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The UnitedHealthcare Medicare Advantage Choice Plan 1 (Region medicare insurance offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $4.00 for 75% low income subsidy $8.00 for 50% and $12.00 for 25%.
| Full LIS Premium: | $0 |
|---|---|
| 75% LIS Premium: | $4.00 |
| 50% LIS Premium: | $8.00 |
| 25% LIS Premium: | $12.00 |
R5342-001 Formulary or Drug Coverage
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers.By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
2021 UnitedHealthcare Medicare Advantage Choice Plan 1 (Region Summary of Benefits
Additional Benefits
| No |
|---|
Comprehensive Dental
| Diagnostic services | Not covered |
|---|---|
| Endodontics | Not covered |
| Extractions | Not covered |
| Non-routine services | Not covered |
| Periodontics | Not covered |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
| Restorative services | Not covered |
Deductible
| $0 |
|---|
Diagnostic Tests and Procedures
| Diagnostic radiology services (e.g., MRI) | $0-160 copay |
|---|---|
| Diagnostic radiology services (e.g., MRI) | 40% coinsurance (Out-of-Network) |
| Diagnostic tests and procedures | $30 copay |
| Diagnostic tests and procedures | 40% coinsurance (Out-of-Network) |
| Lab services | $0 copay (Out-of-Network) |
| Lab services | $0 copay |
| Outpatient x-rays | $50 copay (Out-of-Network) |
| Outpatient x-rays | $50 copay |
Doctor Visits
| Primary | $50 copay per visit (Out-of-Network) |
|---|---|
| Primary | $0 copay |
| Specialist | $45 copay per visit |
| Specialist | $75 copay per visit (Out-of-Network) |
Emergency care/Urgent Care
| Emergency | $90 copay per visit (always covered) |
|---|---|
| Urgent care | $30-40 copay per visit (always covered) |
Foot Care (podiatry services)
| Foot exams and treatment | $75 copay (Out-of-Network) |
|---|---|
| Foot exams and treatment | $45 copay |
| Routine foot care | $75 copay (Out-of-Network) |
| Routine foot care | $45 copay |
Ground Ambulance
| $250 copay |
|---|
| $250 copay (Out-of-Network) |
United Healthcare Therapy Copay Program
Hearing
| Fitting/evaluation | Not covered |
|---|---|
| Hearing aids | $375 copay (Out-of-Network) |
| Hearing aids | $375-2,075 copay |
| Hearing exam | $75 copay (Out-of-Network) |
| Hearing exam | $0 copay |
Inpatient Hospital Coverage
| $375 per day for days 1 through 5 $0 per day for days 6 through 90 $0 per day for days 91 and beyond |
|---|
| $500 per day for days 1 through 20 $0 per day for days 21 and beyond (Out-of-Network) |
Medical Equipment/Supplies
| Diabetes supplies | 40% coinsurance per item (Out-of-Network) |
|---|---|
| Diabetes supplies | $0 copay per item |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 50% coinsurance per item (Out-of-Network) |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs) | 40% coinsurance per item (Out-of-Network) |
Medicare Part B Drugs
| Chemotherapy | 40% coinsurance (Out-of-Network) |
|---|---|
| Chemotherapy | 20% coinsurance |
| Other Part B drugs | 20% coinsurance |
| Other Part B drugs | 40% coinsurance (Out-of-Network) |
Mental Health Services
| Inpatient hospital - psychiatric | $500 per day for days 1 through 20 $0 per day for days 21 through 90 (Out-of-Network) |
|---|---|
| Inpatient hospital - psychiatric | $375 per day for days 1 through 4 $0 per day for days 5 through 90 |
| Outpatient group therapy visit | $30-40 copay (Out-of-Network) |
| Outpatient group therapy visit | $15 copay |
| Outpatient group therapy visit with a psychiatrist | $15 copay |
| Outpatient group therapy visit with a psychiatrist | $30-40 copay (Out-of-Network) |
| Outpatient individual therapy visit | $30-40 copay (Out-of-Network) |
| Outpatient individual therapy visit | $25 copay |
| Outpatient individual therapy visit with a psychiatrist | $30-40 copay (Out-of-Network) |
| Outpatient individual therapy visit with a psychiatrist | $25 copay |
MOOP
| $10,000 In and Out-of-network $6,700 In-network |
|---|
Option
Urgent Care Copay United Healthcare
| No |
|---|
Optional supplemental benefits
| Yes |
|---|
Outpatient Hospital Coverage
| $0-325 copay per visit |
|---|
| 40% coinsurance per visit (Out-of-Network) |
Package #1
| Deductible | |
|---|---|
| Monthly Premium | $40.00 |
Preventive Care
| $0 copay |
|---|
| 0-40% coinsurance (Out-of-Network) |
Preventive Dental
| Cleaning | $0 copay |
|---|---|
| Cleaning | $0 copay (Out-of-Network) |
| Dental x-ray(s) | $0 copay (Out-of-Network) |
| Dental x-ray(s) | $0 copay |
| Fluoride treatment | $0 copay (Out-of-Network) |
| Fluoride treatment | $0 copay |
| Oral exam | $0 copay (Out-of-Network) |
| Oral exam | $0 copay |
Rehabilitation Services
| Occupational therapy visit | $75 copay (Out-of-Network) |
|---|---|
| Occupational therapy visit | $40 copay |
| Physical therapy and speech and language therapy visit | $40 copay |
| Physical therapy and speech and language therapy visit | $75 copay (Out-of-Network) |
Skilled Nursing Facility
| $0 per day for days 1 through 20 $184 per day for days 21 through 57 $0 per day for days 58 through 100 |
|---|
| $225 per day for days 1 through 45 $0 per day for days 46 through 100 (Out-of-Network) |
Transportation
| Not covered |
|---|
Vision
| Contact lenses | $0 copay (Out-of-Network) |
|---|---|
| Contact lenses | $0 copay |
| Eyeglass frames | Not covered |
| Eyeglass lenses | Not covered |
| Eyeglasses (frames and lenses) | $0 copay (Out-of-Network) |
| Eyeglasses (frames and lenses) | $0 copay |
| Other | Not covered |
| Routine eye exam | $0 copay |
| Routine eye exam | $75 copay (Out-of-Network) |
| Upgrades | Not covered |
Wellness Programs (e.g. fitness nursing hotline)
| Covered |
|---|
Reviews for UnitedHealthcare Medicare Advantage Choice Plan 1 (Region R5342
| 2019 Overall Rating |
|---|
| Part C Summary Rating |
| Part D Summary 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 |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating |
|---|
| Breast Cancer Screening |
| Colorectal Cancer Screening |
| Annual Flu Vaccine |
| Improving Physical |
| Improving Mental Health |
| Monitoring Physical Activity |
| Adult BMI Assessment |
Managing Chronic And Long Term Care for Older Adults
| Total Rating |
|---|
| SNP Care Management |
| Medication Review |
| Functional Status Assessment |
| Pain Screening |
| Osteoporosis Management |
| Diabetes Care - Eye Exam |
| Diabetes Care - Kidney Disease |
| Diabetes Care - Blood Sugar |
| Rheumatoid Arthritis |
| Reducing Risk of Falling |
| Improving Bladder Control |
| Medication Reconciliation |
| Statin Therapy |
Member Experience with Health Plan
| Total Experience Rating |
|---|
| Getting Needed Care |
| Customer Service |
| Health Care Quality |
| Rating of Health Plan |
| Care Coordination |
Member Complaints and Changes in UnitedHealthcare Medicare Advantage Choice Plan 1 (Region Plans Performance
| Total Rating |
|---|
| Complaints about Health Plan |
| Members Leaving the Plan |
| Health Plan Quality Improvement |
| Timely Decisions About Appeals |
Health Plan Customer Service Rating for UnitedHealthcare Medicare Advantage Choice Plan 1 (Region
| Total Customer Service Rating |
|---|
| Reviewing Appeals Decisions |
| Call Center, TTY, Foreign Language |
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region Drug Plan Customer Service Ratings
| Total Rating |
|---|
| Call Center, TTY, Foreign Language |
| Appeals Auto |
| Appeals Upheld |
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating |
|---|
| Complaints about the Drug Plan |
| Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement |
Member Experience with the Drug Plan
| Total Rating |
|---|
| Rating of Drug Plan |
| Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
| Total Rating |
|---|
| MPF Price Accuracy |
| Drug Adherence for Diabetes Medications |
| Drug Adherence for Hypertension (RAS antagonists) |
| Drug Adherence for Cholesterol (Statins) |
| MTM Program Completion Rate for CMR |
| Statin with Diabetes |
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST
Coverage Area for UnitedHealthcare Medicare Advantage Choice Plan 1 (Region
(Click county to compare all available Advantage plans)
| State: | New York |
|---|---|
| County: | Albany,Allegany,Bronx,Broome,Cattaraugus, Cayuga,Chautauqua,Chemung,Chenango, Clinton,Columbia,Cortland,Delaware, Dutchess,Erie,Essex,Franklin, Fulton,Genesee,Greene,Hamilton, Herkimer,Jefferson,Kings,Lewis, Livingston,Madison,Monroe,Montgomery, Nassau,New York,Niagara,Oneida, Onondaga,Ontario,Orange,Orleans, Oswego,Otsego,Putnam,Queens, Rensselaer,Richmond,Rockland,Saratoga, Schenectady,Schoharie,Schuyler,Seneca, St. Lawrence,Steuben,Suffolk,Sullivan, Tioga,Tompkins,Ulster,Warren, Washington,Wayne,Westchester,Wyoming, Yates, |
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Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.