Council on Aging Answers 2015 - 110

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
unitedhealthcare
medicarecomplete essential plan

unitedhealthcare
medicarecomplete premier plan

unitedhealthcare
medicare complete securehorizons
plan 2

New enrollment:
855-248-5383
Current members:
800-950-9355
AARpmedicareplans.com
ma only (hmo) medicare Advantage plan only.
NO prescription Drug benefit. must utilize plan
physicians, providers and hospitals.
$0 monthly premium

New enrollment:
855-248-5383
Current members:
800-950-9355
AARpmedicareplans.com
ma-pd (hmo) medicare Advantage plan with
prescription Drug benefit. must utilize plan
physicians, providers and hospitals.
$0 monthly premium

4001-4500 physicians and providers
$4,900 In-Network
$5 each visit
$10 each visit
Days 1-5: $150/day. Days 6-90: $0. $0/day after 90
days. Unlimited days each benefit period.

3501-4000 physicians and providers
$3,400 In-Network
$0 each visit
$0 each visit
Days 1-90: $0. $0/day beyond 91 days. Unlimited
days each benefit period.

skilled nursing facility

4501-5000 physicians and providers
$4,900 In-Network
$5 each visit
$10 each visit
$50 each stay. $0/day for days 91 and beyond.
Unlimited days each benefit period. Contact plan
for more details.
Days 1-20: $0/day, Days 21-52: $155/day, Days
53-100: $0/day. 100 days each benefit period.

Days 1-20: $0/day, Days 21-52: $155/day, Days
53-100: $0/day. 100 days each benefit period.

Days 1-20: $0/day, Days 21-43: $150/day, Days 44100: $0/day. 100 days each benefit period.

in-patient mental health

$50 each stay. 190-day psychiatric hospital lifetime Days 1-5: $150/day. Days 6-90: $0/day. 190-day
limit.
psychiatric hospital lifetime limit.

Days 1-90: $0/day. 190-day psychiatric hospital
lifetime limit.

$30 each individual or group therapy visit.

$0 each visit

$125 each visit

$0 each visit

$250 each service

telephone numbers Website

plan type
monthly health and
drug plan premium
size of netWork
out of pocket maximum
doctor visit
specialist visit
in-patient hospitalization

outpatient mental health
outpatient hospital services
ambulance
emergency room visit
outpatient rehab services

$65 each visit, waived if admitted within 24-hours. $65 each visit, waived if admitted within 24-hours. $65 each visit, waived if admitted within 24-hours.
$10 each visit
$10 each visit
$0 each visit

x-rays

lab services
part b chemotherapy drugs

20% of cost for medicare-covered items.

20% of cost for diagnostic procedures and tests.
20% of cost for diagnostic radiology services.

$0 copay for diagnostic procedures and tests. $50
copay for diagnostic radiology services.

$0 each x-ray

$0 for lab services. 20% of cost for therapeutic
radiology services.

$13 for lab services. 20% of cost for therapeutic
radiology services.

$0 for lab services. $50 copay for therapeutic
radiology services.

20% of the cost for part b chemotherapy drugs

$10 copay for medicare-covered benefits.

diagnostic tests

20% of cost for medicare-covered items.

$0 each x-ray

durable medical equipment

$10 copay for medicare-covered benefits.

$0 copay for medicare-covered benefits.

$10 copay for diagnostic exams. $5 for up to 1
routine exam/yr. $330-$380 copay each hearing
aid

$0 copay for diagnostic exams. $0 for up to 1
routine exam/yr. $330-$380 copay each hearing
aid

$0-$10 copay to diagnose & treat eye conditions.
$0 for eyewear after cataract surgery. $10 for up
to 1 routine exam/yr. $0 for contacts. $0 for up
to 1 pair of lenses, frames/yr. ($125 limit/yr. for
contacts; $130 limit/yr. for frames)

$0-$10 copay to diagnose & treat eye conditions.
$0 for eyewear after cataract surgery. $10 for up to
1 routine exam/yr. $30 for contacts. $30 for up to 1
pair of frames/2 yrs. $0 for up to 1 pair of lenses/2
yrs. ($105 limit/2 yrs. for contacts; $70 limit/2 yrs.
for frames)

$0 copay to diagnose & treat eye conditions. $0
for eyewear after cataract surgery. $0 for up to 1
routine exam/yr. $30 for contacts. $30 for up to 1
pair of frames/2 yrs. $0 for up to 1 pair of lenses/2
yrs. ($105 limit/2 yrs. for contacts; $70 limit/2 yrs.
for frames)

dental services

HeARING SeRvICeS

vISION SeRvICeS

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
110

Answers Guide 2015

COUNCIl ON on these charts is subJect to NONpROFIT CORpORATION. TO DISTRIbUTe ANSweRS FRee OF COST, we for medicare and medicaid Services on the date of publication. lISTINGS IN ANSweRS, THeIR
the informationAGING - ORANGe COUNTY IS A 501 (C)3change. This information is the most current available from the CentermUST Sell ADveRTISING SpACe. wHIle we AppReCIATe THe pAIDConsumers need to verify this
Aging and Disability Resource Connection | 800-510-2020 | www.adrcoc.org
INClUSION does notwww.medicare.gov as updatesor endorsement ofCOAOC is not or services by coaoc. AlwAYScanA vIGIlANT CONSUmeR. veRIFY INFORmATION ANDvia our HICAp program 1-800-434-0222.
information at imply a recommendation are frequently made. products responsible for these changes but be help with accessing the most current information SeeK ReFeReNCeS wHeRe AppROpRIATe.

http://www.AARpmedicareplans.com http://www.AARpmedicareplans.com http://www.AARpmedicareplans.com http://www.medicare.gov

Council on Aging Answers 2015

Table of Contents for the Digital Edition of Council on Aging Answers 2015