H5253 041 - Y0066_ANOC_H5253_041_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 ...

 
1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Plan 1 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $27.00 (see Plan Premium Details below) Annual Deductible: $0. . Single family house for rent craigslist

H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H5253_041_000_2022_M Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 plan for North Carolina. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 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. H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M Jan 1, 2023 · Summary of Benefits 2023 AARP® Medicare Advantage Plan 1 (HMO-POS) H5253-111-001 Look inside to take advantage of the health services and drug coverages the plan provides. Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 Service area: North Carolina - Alamance, Alexander, Anson, Bertie, Bladen, Buncombe, Burke, Number of Members enrolled in this plan in (H5253 - 041): 23,173 members : Plan’s Summary Star Rating: 4 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 ... 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. Y0066_ANOC_H5253_041_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 ... Y0066_ANOC_H5253_041_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año 533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ... Original Medicare. Dr. Miller accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Durham, North Carolina locations accept Part B plans, though some require both Part A and Part B. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Original Medicare. Chinyere E. accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Durham, North Carolina locations accept Part B plans, though some require both Part A and Part B. Y0066_ANOC_H5253_041_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 ... The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 2,168 members enrolled in this plan in Buncombe, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Jan 1, 2023 · H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Catawba, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-041-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-116-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H1889-005-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5253-041-000 Oak Street Health Gate City accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Greensboro, North Carolina locations accept Part B plans, though some require both Part A and Part B. 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Plan 1 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $27.00 (see Plan Premium Details below) Annual Deductible: $0. Sep 26, 2022 · Summary of Benefits 2023 UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H5253-116-000 Look inside to take advantage of the health services and drug coverages the plan provides. Jan 1, 2023 · H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Y0066_ANOC_H5253_041_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 ... Oct 1, 2022 · Wellcare by Health Net for California Post Office Box 10420 Van Nuys, CA 91410 From October 1 – March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 Service area: North Carolina - Alamance, Alexander, Anson, Bertie, Bladen, Buncombe, Burke, H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-041-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-116-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H1889-005-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5253-041-000 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-041-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-116-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H1889-005-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5253-041-000 533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ... We would like to show you a description here but the site won’t allow us. The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 2,168 members enrolled in this plan in Buncombe, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. H5253-041: Download: AARP Medicare Advantage Walgreens (HMO-POS) 2023: H5253-110: Download: UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) 2023: R1548-001: Download: AARP Medicare Advantage Plan 3 (HMO-POS) 2023: H5253-117: UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) 2023: H5253-116: UnitedHealthcare Dual Complete Choice (PPO ... Sep 1, 2023 · UnitedHealthcare Dual Complete (HMO-POS D-SNP) You're viewing plan details for. 27053 Alamance County. Update your ZIP Code to view accurate plan details for your area. Monthly Premium. $ 0 - $ 38.40. Primary Care Provider. $ 0 copay - 20 % of the cost. Out-of-Pocket Maximum. The average monthly premium for Medicare Advantage plans in Wake is $9.46 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Wake County have an average Medicare Star Rating of 3.90 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare plans. Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. H5253-041-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-855-545-9340, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. Y0066_ANOC_H5253_041_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año Copayment for Hearing Aids $175.00 to $1225.00. Maximum 2 Hearing Aids every year. Prior Authorization Required for Hearing Aids. Section B - General 18b Note - NOTE ON COST SHARING: Copays will range from a minimum copay of $175 to a maximum of $1 ,225 based on features and style. Details. Dental care. In-Network: Preventive Dental: Maximum Plan Allowance of $1500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Comprehensive Dental: Copayment for Medicare-covered Benefits $30.00. Sep 26, 2022 · AARP® Medicare Advantage Plan 2 (HMO-POS) dummy spacing Benefits In-Network Inpatient Hospital Care2 $250 copay per day: days 1-5 $0 copay per day: days 6 and beyond Our plan covers an unlimited number of days for an Sep 26, 2022 · Summary of Benefits 2023 UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H5253-116-000 Look inside to take advantage of the health services and drug coverages the plan provides. Oct 1, 2022 · Wellcare by Health Net for California Post Office Box 10420 Van Nuys, CA 91410 From October 1 – March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 545 members enrolled in this plan in Orange, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ... Sep 27, 2022 · 1 2023-H3146.006.1 H3146-006 Aetna Medicare Value Plus Plan (HMO) H3146 ‑ 006 Here’s a summary of the services we cover from January 1, 2023 through Decembe H5253-041-000 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 1-855-545-9340, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5253_041_000_2023_M 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 545 members enrolled in this plan in Orange, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Davidson, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Y0066_ANOC_H5253_041_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año The UnitedHealthcare Dual Complete (HMO-POS D-SNP) (H5253 - 041) currently has 43,512 members. There are 2,168 members enrolled in this plan in Buncombe, North Carolina, and 43,321 members in North Carolina. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Buncombe, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Oak Street Health Gate City accepts Original Medicare Part A and Part B plans. Also known as traditional Medicare, Original Medicare is a fee-for-service plan, with Medicare paying a portion of the bill for Medicare covered services. Our Greensboro, North Carolina locations accept Part B plans, though some require both Part A and Part B. Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage H5253-041-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-855-545-9340, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com The average monthly premium for Medicare Advantage plans in Wake is $9.46 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Wake County have an average Medicare Star Rating of 3.90 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare plans. 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. Y0066_ANOC_H5253_041_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año 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. 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-041-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5253-116-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H1889-005-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5253-041-000 2020 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Guilford, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Sep 26, 2022 · AARP® Medicare Advantage Plan 2 (HMO-POS) dummy spacing Benefits In-Network Inpatient Hospital Care2 $250 copay per day: days 1-5 $0 copay per day: days 6 and beyond Our plan covers an unlimited number of days for an 3 Your Summary of Benefits “Medicare & You” handbook. View it online at www.medicare.gov or get a copy by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. Need to contact us? Use this reference guide for quick access to a variety of helpful resources. UnitedHealthcare Provider Portal The UnitedHealthcare Provider Portal is your gateway to the Need to contact us? Use this reference guide for quick access to a variety of helpful resources. UnitedHealthcare Provider Portal The UnitedHealthcare Provider Portal is your gateway to the The average monthly premium for Medicare Advantage plans in Wake is $9.46 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Wake County have an average Medicare Star Rating of 3.90 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare plans. Sep 26, 2022 · Summary of Benefits 2023 UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H5253-116-000 Look inside to take advantage of the health services and drug coverages the plan provides.

533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ... . Tory

h5253 041

2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Catawba, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Plan 2 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $28.00 (see Plan Premium Details below) Annual Deductible: $0. Annual Initial Coverage Limit (ICL): Number of Members enrolled in this plan in (H5253 - 041): 71,322 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 ... Sep 26, 2022 · AARP® Medicare Advantage Plan 2 (HMO-POS) dummy spacing Benefits In-Network Inpatient Hospital Care2 $250 copay per day: days 1-5 $0 copay per day: days 6 and beyond Our plan covers an unlimited number of days for an AARP Medicare Advantage 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). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $20.00. Prior Authorization Required for Chiropractic Services. Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 Service area: North Carolina - Alamance, Alexander, Anson, Bertie, Bladen, Buncombe, Burke, 2020 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Guilford, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 - 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 Y0066_EOC_H5253_041_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5253-041-000 Service area: North Carolina - Alamance, Alexander, Anson, Bertie, Bladen, Buncombe, Burke, 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. 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Durham, North Carolina Click to see other locations. Plan ID: H5253 - 041 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Jan 1, 2023 · Summary of Benefits 2023 AARP® Medicare Advantage Plan 1 (HMO-POS) H5253-111-001 Look inside to take advantage of the health services and drug coverages the plan provides. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Plan 2 (HMO-POS) benefit details. — Medicare Plan Features —. Monthly Premium: $28.00 (see Plan Premium Details below) Annual Deductible: $0. Annual Initial Coverage Limit (ICL): Details. Dental care. In-Network: Preventive Dental: Maximum Plan Allowance of $1500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Comprehensive Dental: Copayment for Medicare-covered Benefits $30.00. .

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