AARP Medicare Advantage SecureHorizons 2 Plan (HMO-POS) H0543-147 2022 Plan Details and Costs (2023)

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AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS) is a Medicare Advantage HMO-POS Plan (Medicare Part C) offered by UnitedHealthcare.
Plan-ID: H0543-147.

p.s9.00

Monthly Premium

AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS) is a Medicare Advantage HMO-POS Plan (Medicare Part C) offered by UnitedHealthcare.
Plan-ID: H0543-147.

AARP Medicare Advantage SecureHorizons 2 Plan (HMO-POS) H0543-147 2022 Plan Details and Costs (2)

AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS) H0543-147 Plandetails

4 out of 5 stars

AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS) is a Medicare Advantage HMO-POS Plan (Medicare Part C) offered by UnitedHealthcare.
Plan-ID: H0543-147.

p.s9.00

Monthly Premium

California counties served

Stanislaus

Base Costs and Coverage

Roof Cost
monthly deductible $0
out of pocket at most In the network:$3900
From the web:N / A
Initial Coverage Limit $4660
Catastrophic Coverage 7.400 $
GP visit

In the network:

Visit to the doctor's office:
Visit to the office of primary care copay0,00 $

Visit to the specialist

In the network:

Specialist visit:
Specialist visit copay$15,00
Prior authorization is required to see a specialist
Referral for specialist visit required
prior approval is required

Inpatient hospital care

In the network:

Services in the acute hospital:
$220,00per day for days 1 to 8
0,00 $per day for days 9 to 90
Prior approval is required for acute hospital services
A referral is required for acute hospital services
prior approval is required

emergency care

Emergency care co-payment$40,00

Worldwide Coverage:
Co-payment for global emergency response0,00 $

Visit to the emergency room

Emergency care co-payment$90,00
Waiver of co-payment for Medicare-covered emergency care if you are hospitalized within 24 hours

Worldwide Coverage:
Co-pay for global emergency response0,00 $
Worldwide Emergency Transportation Co-Payment0,00 $

ambulance

In the network:

Ambulance:
Co-payment for ground rescue services$250,00

Ambulance:
Co-payment for air ambulance services$250,00

Section B - General 10a Notice - AUTHORIZATION NOTE: Medicare-covered non-emergency ground and air ambulance transport requires an authorization. The ambulance does not require a permit. Section B - General 10a Notice - REFERRAL NOTICE: Referrals are required for Medicare-covered non-emergency ground and ambulance transport. The emergency services do not require a referral.
Please note the rules on pre-approval in the proof of cover.
prior approval is required

health services and medical supplies

AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Roof Cost
Chiropractic Services

In the network:
Co-payment for Medicare-covered chiropractic services$15,00
Prior approval is required for chiropractic services
A referral is required for chiropractic services
prior approval is required

Diabetes care, education, nutritional therapy and monitoring

In the network:
Copay for Medicare covered diabetic items0,00 $
Co-insurance for Medicare-covered diabetic therapy shoes or insoles20%
Prior approval is required for diabetic services and supplies
prior approval is required

Durable Medical Equipment (DME)

In the network:
Co-insurance for Medicare-covered long-life medical devices20%
Prior approval is required for long-life medical devices
prior approval is required

Diagnostic testing, laboratory and radiology services and X-rays

In the network:

Outpatient diagnostic procedures/examinations/laboratory services:
Co-payment for Medicare-covered diagnostic procedures/tests0,00 $
Copay for Medicare-covered laboratory services0,00 $
Prior approval is required for ambulatory laboratory/testing/diagnostic processing services
Referral required for outpatient diagnostic procedures/tests/laboratory services

Outpatient radiodiagnostic/therapeutic services:
Co-payment for Medicare-covered diagnostic radiology services0,00 $A$55,00
Co-payment for Medicare-covered therapeutic radiology services$60,00
Co-payment for Medicare-covered X-ray services$15,00
Prior approval is required for outpatient diagnostic/therapeutic services
A referral is required for outpatient diagnostic/therapeutic services
prior approval is required

Home care

In the network:
Co-payment for Medicare-covered home healthcare services0,00 $
Prior authorization is required for GP services
A referral is required for GP services
prior approval is required

Inpatient psychiatric care

In the network:

Psychiatric hospital services:
$220,00per day for days 1 to 8
0,00 $per day for days 9 to 90
Prior approval is required for psychiatric hospital services
A referral is required for psychiatric hospital services
prior approval is required

Outpatient psychiatric care

In the network:
Co-payment for Medicare-covered individual sessions$25,00
Copay for Medicare-covered group sessions$15,00
Prior approval is required for outpatient mental health services
A referral is required for outpatient mental health services
prior approval is required

Ambulatory Services / Surgery

In the network:

Hospital ambulances:
Co-payment for Medicare-covered outpatient hospital services0,00 $A195,00 $
Prior approval is required for outpatient hospital services
A referral is required for outpatient hospital services

Ambulatory Observation Services:
Co-payment for Medicare-covered monitoring services: per day195,00 $
Prior approval is required for outpatient observation services
A referral is required for outpatient observation services

Ambulatory surgery center services:
Co-payment for outpatient surgical center services0,00 $A195,00 $
Prior approval is required for outpatient surgical center services
A referral is required for outpatient surgical centers
prior approval is required

Outpatient addiction help

In the network:
Co-payment for Medicare-covered individual sessions$25,00
Copay for Medicare-covered group sessions$15,00
Prior approval is required for outpatient substance abuse services
Referral required for outpatient substance abuse services
prior approval is required

Over-the-Counter (OTC)-Artikel

In the network:

Over-the-Counter (OTC)-Artikel:
Copay for Over-the-Counter (OTC) items0,00 $
Maximum plan utility$40,00every three months
Nicotine Replacement Therapy (NRT) provided as an OTC service pursuant to Part C

podiatry services

In the network:
Copay for Medicare-covered podiatry services$15,00
Co-payment for routine foot care$15,00

  • Maximum 6 visits per year

Prior authorization is required for podiatry services
A referral is required for podiatry services
prior approval is required

Care in a qualified care facility

In the network:

Qualified care service:
0,00 $per day for days 1 to 20
196,00 $per day for days 21 to 40
0,00 $per day for days 41 to 100
Prior approval is required for qualified care facilities
A referral is required for qualified care facilities
prior approval is required

Dental Benefits

The following dental services are provided by in-network providers.

Roof Cost
dental care

In the network:

Preventive Dentistry:
Additional payment for oral exams0,00 $

  • Maximum 2 visits per year

Surcharge for prophylaxis (cleaning)0,00 $

  • Maximum 3 visits per year

Surcharge for fluoride treatment0,00 $

  • Maximum 2 visits per year

Co-payment for dental X-ray0,00 $

  • Maximum 1 visit every three years

Comprehensive Dentistry:
Co-insurance for Medicare-covered services20%
Prior approval is required for full dental services
A referral is required for full dental services
prior approval is required

POS (off-grid):

Dental services not covered by Medicare:
Co-payment for preventative dental services not covered by Medicare0,00 $

Sehvorteil

The following image processing services are covered by in-network providers.

Roof Cost
Sehvorteil

In the network:

eye exams:
Co-payment for Medicare-covered benefits0,00 $
Co-payment for routine eye exams0,00 $

  • Maximum 1 routine eye exam per year

Prior approval is required for eye exams
A referral is required for eye exams

Glasses:
Co-payment for Medicare-covered benefits0,00 $
Supplement for contact lenses0,00 $
Additional payment for glasses (lenses and frames)0,00 $

  • Maximum 1 pair per year

Maximum plan utility$100,00each year for all glasses not covered by Medicare
Reference required for glasses
prior approval is required

hearing benefits

The following listening services are covered by in-network providers.

Roof Cost
hearing benefits

In the network:

Hearing Tests:
Co-payment for Medicare-covered benefits0,00 $
Co-payment for routine hearing tests0,00 $

  • Maximum 1 visit per year

Prior approval is required for hearing tests
A referral is required for hearing tests

Headphones:
Co-payment for hearing aids175,00 $A$1225,00

  • Maximum 2 hearing aids per year

Prior approval is required for hearing aids
Section B - General 18b Notice - SHARING COSTS NOTE: Co-payments range from a minimum co-payment of$175up to max$1.225 based on features and style. COMBINED HEARING AIDS INSURANCE NOTICE: Member may purchase a total of two hearing aids each year.
prior approval is required

Preventive services and health/wellness educational programs

The following services are covered by in-network providers.

Roof Cost
Preventive services and health/wellness educational programs

In the network:
0,00 $Co-payment for Medicare-covered prevention services:

Screening for abdominal aortic aneurysm
Counseling and screening for alcohol abuse
Bone mass measurements (bone density)
Cardiovascular disease screening
Cardiovascular diseases (behavioral therapy)
Screening for cervical and vaginal cancer
Colorectal Cancer Prevention
Depressionsscreenings
Diabetes-Screenings
Diabetes self-management training
Glaucoma-Test
Screening for hepatitis B infection (HBV)
Hepatitis-C-Screening
HIV-Screening
lung cancer screening
Mammographie (Screening)
nutritional therapy services.
Obesity screening and counseling
Welcome to Medicare One Time Preventive Visit
Prostate Cancer Screening Tests (PSA)
Screening and counseling for sexually transmitted infections
shots:

  • Covid-19 vaccinations
  • flu shots
  • Hepatitis B vaccines
  • pneumococcal vaccines
  • cessation of tobacco use
    Visit the annual "Wellness"

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