H0169 002 - 2019 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.

 
Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage . Dollar400 apartments near me

UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. 2019 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating DetailsThe UnitedHealthcare Dual Complete LP1 (HMO-POS D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply. Emergency care/Urgent care. • Emergency: $0 or $90 copay per visit (always covered) • Urgent care: $0 or $65 copay per visit (always covered) Inpatient hospital coverage. • In 2020 the amounts for each benefit period are $0 or: $1,408 deductible for days 1 through 60. $352 copay per day for days 61 through 90. Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger,2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2. 2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits ExplainedMedicare options – Missouri only unless stated otherwise. Medicare – Medicare Part B (called traditional Medicare) is managed by the government agency called Centers for Medicare and Medicaid Services or CMS. This plan issues a red, white and blue enrollment card. For information or to enroll call 800-633-4227.Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000H0169-002-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MY0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating DetailsUnitedHealthcare Community Plan2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Jackson, Missouri Click to see other locations. Plan ID: H0169 - 002 - 0 Click to see other plans. Member Services: 1-844-368-6886 TTY users 711.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating Details UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan.Number of Members enrolled in this plan in (H0169 - 001): 14,992 members : Plan’s Summary Star Rating: 5 out of 5 Stars. This plan qualifies for the 5-star rating Special Enrollment period. Read more. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars.Emergency care/Urgent care. • Emergency: $0 or $90 copay per visit (always covered) • Urgent care: $0 or $65 copay per visit (always covered) Inpatient hospital coverage. • In 2020 the amounts for each benefit period are $0 or: $1,408 deductible for days 1 through 60. $352 copay per day for days 61 through 90. Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security NumberH0169-002-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MY0066_ANOC_H0169_002_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ... As an Arkansas Blue Medicare member, you’ll be eligible to earn valuable rewards for getting exams, preventive screenings, tests and completing other health-related activities. Comprehensive dental benefits. $0 copay for 1 routine hearing exam per year. $699/$999 copay per hearing aid (2 per year) Please see plan documents for more details.Información sobre proveedores UnitedHealthcare Dual Complete® (HMO-POS D-SNP) Aprovechará los beneficios adicionales de su plan si usa los proveedores indicados a continuaciónVendor Information UnitedHealthcare Dual Complete® (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contacting2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Pulaski, Missouri Click to see other locations. Plan ID: H0169 - 002 - 0 Click to see other plans. Member Services: 1-844-368-6886 TTY users 711.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits DetailsY0066_EOC_H0169_004_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.UnitedHealthcare Dual Complete Plan 1 (HMO-POS D-SNP) covers a range of additional benefits. Learn more about UnitedHealthcare Dual Complete Plan 1 (HMO-POS D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B). Diabetes supplies, training, nutrition therapy and monitoring. 2021 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans. Feb 22, 2011 · Medicare Advantage & Other Health Plans in Iowa 2023 Iowa Insurance Division 1963 Bell Ave, Suite 100, Des Moines, IA 50315 1-800-351-4664 TTY 1-800-735-2942 The UnitedHealthcare Dual Complete (HMO SNP) (H0169 - 002) currently has 8,801 members. There are 28 members enrolled in this plan in Barry, Missouri, and 8,695 members in Missouri. Prescription Drug Coverage: Deductible, Cost-sharing, Formulary: This plan has a $415 deductible. So, you are 100% responsible for the first $415 in medication costs.Y0066_ANOC_H0169_002_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ... 2023 Missouri UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: H0169-002-000 Subject: UnitedHealthcare Community Plan of Missouri manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Created Date: 20230218034507Z o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security NumberThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 2018 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.This page features plan details for 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169 – 002 – 0 available in Select Counties in Missouri. IMPORTANT : This page has been updated with plan and premium data for 2023.H0169-002-000 MO HMO UnitedHealthcare Dual Complete Dual Neither H0169-003-000 NE HMO UnitedHealthcare Dual Complete Dual Neither H0169-004-000 KS HMOPOS UnitedHealthcare Dual Complete LP1 Dual Neither H0251-002-000 TN HMO UnitedHealthcare Dual Complete Dual Neither VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.UnitedHealthcare Dual Complete (HMO-POS D-SNP) 4.5 out of 5 stars. UnitedHealthcare Dual Complete (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0169-002. $ 0.00.2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.The following UnitedHealthCare plans are accepted at Oak Street Health locations. Plan Name. Effective Year. Benefit Package. Summary. AARP Medicare Advantage. 2023. H1944-024. AARP Medicare Advantage.Medicare Advantage & Other Health Plans in Iowa 2023 Iowa Insurance Division 1963 Bell Ave, Suite 100, Des Moines, IA 50315 1-800-351-4664 TTY 1-800-735-2942UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. 002 hamaspik, inc. fide 001 ny h0111 004 wellcare of georgia, inc. ga h0154 012 viva health, inc. al 019 h0169 unitedhealthcare of the midwest, inc. ia ks hide 003 h0174 wellcare of texas, inc. 006 h0251 005 unitedhealthcare plan of the river valley, inc. tn h0270 wellcare health insurance company of america ar h0271 023 014 ct in me 020 028 mi ...Y0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-006-000 plan for Nebraska. Check eligibility, explore benefits, and enroll today. Number of Members enrolled in this plan in (H0169 - 002): 14,549 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Number of Members enrolled in this plan in (H0169 - 002): 14,549 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Plan ID: H0169-003-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly PremiumMaximum 3 visits every year. Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Maximum 3 visits every year. Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.The UnitedHealthcare Dual Complete (HMO SNP) (H0169 - 002) currently has 8,801 members. There are 28 members enrolled in this plan in Barry, Missouri, and 8,695 members in Missouri. Prescription Drug Coverage: Deductible, Cost-sharing, Formulary: This plan has a $415 deductible. So, you are 100% responsible for the first $415 in medication costs.VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.Number of Members enrolled in this plan in (H0169 - 002): 14,549 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Number of Members enrolled in this plan in (H0169 - 002): 14,549 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Jan 1, 2023 · H0169-001-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_001_000_2023_M UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ FemeninoMedicare Advantage & Other Health Plans in Iowa 2023 Iowa Insurance Division 1963 Bell Ave, Suite 100, Des Moines, IA 50315 1-800-351-4664 TTY 1-800-735-2942Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security NumberThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 24,875 members. There are 168 members enrolled in this plan in Barry, Missouri, and 24,793 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as follows: 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-0002022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2018 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for complete list of covered services, limitations and exclusions.Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000Y0066_EOC_H0169_004_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageA federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 455 members enrolled in this plan in Clay, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.Jan 1, 2023 · H0169-004-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_M Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.As an Arkansas Blue Medicare member, you’ll be eligible to earn valuable rewards for getting exams, preventive screenings, tests and completing other health-related activities. Comprehensive dental benefits. $0 copay for 1 routine hearing exam per year. $699/$999 copay per hearing aid (2 per year) Please see plan documents for more details. This page features plan details for 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169 – 002 – 0 available in Select Counties in Missouri. IMPORTANT : This page has been updated with plan and premium data for 2023.2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Jackson, Missouri Click to see other locations. Plan ID: H0169 - 002 - 0 Click to see other plans. Member Services: 1-844-368-6886 TTY users 711.

Medicare options – Missouri only unless stated otherwise. Medicare – Medicare Part B (called traditional Medicare) is managed by the government agency called Centers for Medicare and Medicaid Services or CMS. This plan issues a red, white and blue enrollment card. For information or to enroll call 800-633-4227. . Sabrina

h0169 002

4.5 out of 5 stars* for plan year 2023. $0.00 Monthly Premium. UnitedHealthcare Dual Complete (HMO-POS D-SNP) is a HMO-POS D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0169-002-000.Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-008-000 plan for Missouri. Check eligibility, explore benefits, and enroll today.Y0066_ANOC_H0169_002_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ... As an Arkansas Blue Medicare member, you’ll be eligible to earn valuable rewards for getting exams, preventive screenings, tests and completing other health-related activities. Comprehensive dental benefits. $0 copay for 1 routine hearing exam per year. $699/$999 copay per hearing aid (2 per year) Please see plan documents for more details.o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security Number The UnitedHealthcare Dual Complete LP1 (HMO-POS D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.The UnitedHealthcare Dual Complete (HMO SNP) (H0169 - 002) currently has 8,801 members. There are 28 members enrolled in this plan in Barry, Missouri, and 8,695 members in Missouri. Prescription Drug Coverage: Deductible, Cost-sharing, Formulary: This plan has a $415 deductible. So, you are 100% responsible for the first $415 in medication costs.This page features plan details for 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169 – 002 – 0 available in Select Counties in Missouri. IMPORTANT : This page has been updated with plan and premium data for 2023. 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details Medicare options – Missouri only unless stated otherwise. Medicare – Medicare Part B (called traditional Medicare) is managed by the government agency called Centers for Medicare and Medicaid Services or CMS. This plan issues a red, white and blue enrollment card. For information or to enroll call 800-633-4227..

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