Colorado Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Colorado Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
Coverage
Details
Monthly plan premium
$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible
$0.00
Out-of-pocket maximum
$8,850.00
Initial drug coverage limit
$0.00
Catastrophic drug coverage limit
$8,000.00
Primary care doctor visit
In-Network:
Doctor Office Visit: Copayment for Primary Care Office Visit $0.00
Specialty doctor visit
Out-of-Network:
Doctor Specialty Visit: Coinsurance for Medicare Covered Physician Specialist Office Visit 40%
Inpatient hospital care
Out-of-Network: Copayment for Acute Hospital Services per Stay $0.00
Urgent care
Urgent Care: Copayment for Urgent Care $0.00
Benefit Details - General 4b Note - NOTE ON COST SHARING RANGE FOR URGENTLY NEEDED SERVICES: $0 copayment applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services.
Worldwide Coverage: Copayment for Worldwide Urgent Coverage $0.00
Emergency room visit
Emergency Care: Copayment for Emergency Care $0.00 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours
Worldwide Coverage: Copayment for Worldwide Emergency Coverage $0.00 Copayment for Worldwide Emergency Transportation $0.00
Ambulance transportation
Out-of-Network:
Ambulance Services: Coinsurance for Medicare Covered Ambulance Services - Ground 20% Coinsurance for Medicare Covered Ambulance Services - Air 20%
Health Care Services and Medical Supplies
UHC Dual Complete CO-S001 (PPO D-SNP) covers a range of additional benefits. Learn more about UHC Dual Complete CO-S001 (PPO D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage
Details
Chiropractic services
Out-of-Network:
Chiropractic Services: Coinsurance for Medicare Covered Chiropractic Services 40% Chiropractic Services: Coinsurance for Non-Medicare Covered Chiropractic Services 40%
Diabetes supplies, training, nutrition therapy and monitoring
Out-of-Network:
Diabetic Supplies and Services: Coinsurance for Medicare Covered Diabetic Supplies and Services 40%
Durable medical equipment (DME)
In-Network:
Durable Medical Equipment: Copayment for Medicare-covered Durable Medical Equipment $0.00 Prior Authorization Required for Durable Medical Equipment
Diagnostic tests, lab and radiology services, and X-rays
In-Network:
Outpatient Diag Procs/Tests/Lab Services: Copayment for Medicare-covered Diagnostic Procedures/Tests $0.00 Copayment for Medicare-covered Lab Services $0.00 Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services
Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0.00 Copayment for Medicare-covered Therapeutic Radiological Services $0.00 Copayment for Medicare-covered X-Ray Services $0.00 Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services
Home health care
In-Network:
Home Health Services: Copayment for Medicare-covered Home Health Services $0.00 Prior Authorization Required for Home Health Services
Mental health inpatient care
Out-of-Network: Copayment for Psychiatric Hospital Services per Stay $0.00
Mental health outpatient care
Out-of-Network:
Outpatient Mental Health Services: Coinsurance for Medicare Covered Individual Sessions 40% Coinsurance for Medicare Covered Group Sessions 40%
Outpatient services/surgery
In-Network:
Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0.00 Prior Authorization Required for Outpatient Hospital Services
Outpatient Observation Services: Copayment for Medicare Covered Observation Services $0.00 Prior Authorization Required for Outpatient Observation Services
Ambulatory Surgical Center Services: Copayment for Ambulatory Surgical Center Services $0.00 Prior Authorization Required for Ambulatory Surgical Center Services
Outpatient substance abuse care
Out-of-Network:
Outpatient Substance Abuse Services: Coinsurance for Medicare Covered Individual or Group Sessions 40%
Over-the-counter items
In-Network:
Over-The-Counter (OTC) Items: Copayment for Over-The-Counter (OTC) Items $0.00 Maximum Plan Benefit of $165.00 every month Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit
Podiatry services
Out-of-Network:
Podiatry Services: Coinsurance for Medicare Covered Podiatry Services 40% Podiatry Services: Coinsurance for Non-Medicare Covered Podiatry Services 40%
Skilled Nursing Facility (SNF) care
Out-of-Network: Copayment for Skilled Nursing Facility Services per Stay $0.00
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage
Details
Dental care
Out-of-Network:
Medicare Covered Dental Services: Coinsurance for Medicare Covered Comprehensive Dental 40% Non-Medicare Covered Dental Services: Copayment for Non-Medicare Covered Preventive Dental $0.00 Copayment for Non-Medicare Covered Comprehensive Dental $0.00
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage
Details
Vision benefits
In-Network:
Eye Exams: Copayment for Medicare Covered Benefits $0.00 Copayment for Routine Eye Exams $0.00
Maximum 1 Routine Eye Exam every year
Prior Authorization Required for Eye Exams
Eyewear: Copayment for Medicare-Covered Benefits $0.00 Copayment for Contact Lenses $0.00 Copayment for Eyeglasses (lenses and frames) $0.00
Maximum 1 Pair every year
Maximum Plan Benefit of $300.00 every year for all Non-Medicare covered eyewear for in and out of network services combined
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage
Details
Hearing benefits
In-Network:
Hearing Exams: Copayment for Medicare Covered Benefits $0.00 Copayment for Routine Hearing Exams $0.00
Maximum 1 visit every year
Prior Authorization Required for Hearing Exams
Hearing Aids: Copayment for Hearing Aids $0.00
Maximum 2 Hearing Aids every year
Maximum Plan Benefit of $2000.00 every year both ears combined for in and out of network services combined Prior Authorization Required for Hearing Aids
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage
Details
Preventive services and health/wellness education programs
Out-of-Network:
Medicare-covered Zero Dollar Preventive Services: Coinsurance for Medicare Covered Medicare-covered Preventive Services 0% to 40%
When reviewing Colorado Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Colorado that offer similar benefits at similar or lower prices than the plan above. Call 1-855-580-1854TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
UnitedHealthcare Dual Complete® is for people who have Medicaid and Medicare. You'll keep all your Medicaid benefits, plus you'll get more benefits at no extra cost to you.
UnitedHealthcare Dual Complete plans are Special Needs Plan, also called D-SNPs. Plans like these provide coverage and benefits for people with Medicaid and Medicare. However, SNP plans require members to be enrolled in Medicaid to gain benefits like routine vision exams, medical appointments, and even transportation.
Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).
UHC Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams.
Dual health insurance plans offer benefits and services not typically available through Medicare or Medicaid. With a dual health plan, you'll keep your Medicaid benefits, and you'll get more benefits than Original Medicare with as low as a $0 plan premium.
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