H5322 031 - H5322-031-000 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 www.UHCCommunityPlan.com Y0066_SB_H5322_031_000_2022_M

 
Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com. . Lesly center akey

TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL):Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Alfalfa, Atoka, Beaver, Beckham, Blaine, Caddo, Choctaw, Cimarron, Coal, Comanche ... CSOK23HP0050808_000 Página 1 de 8 Solicitud de Inscripción 2023 o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) 5 out of 5 stars UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00 Monthly Premium Oklahoma Counties Served Introduction facility that is currently Medicare-approved for your specific type of transplant. The plan’s hospital network for organ transplant services is different than the network shown in the “Hospitals” section 5 out of 5 stars UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00 Monthly Premium Oklahoma Counties Served TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL):Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com.Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS)UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) 5 out of 5 stars* for plan year 2023. UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare.UnitedHealthcare Dual Complete® LP (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 (H5322 - 031): 5,075 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 ... 2022 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. You are now accessing JARVIS as: {{loggedInUserName}}, (PID: {{loggedInUserPartyId}}) (WID: {{loggedInUserAgentId}}) Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com.2022 Medicare Part D Browse a Plan Formulary (Drug List) - 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_ANOC_H5322_031_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo añoo UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 ¨ FemeninoY0066_ANOC_H5322_031_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo año5 out of 5 stars UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00 Monthly Premium Oklahoma Counties Served Introduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areaUnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Social Security Number (Required for people who are enrolling in D-SNP plans): _ _ Medicare Number Permanent Residence Street Address (P.O. Box is not allowed) City County State ZIP Code Mailing Address (Only if it’s different from above. You can give a P.O. Box.) CityMaximum 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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Number of Members enrolled in this plan in (H5322 - 031): 5,075 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 ...H5322-031-000 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_H5322_031_000_2023_MIntroduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areaCigna Alliance Medicare (HMO) H3949-031 1 Summary of Benefits H3949_23_791509_M Better benefits supported by a dedicated network of providers with no referrals required To Join You must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in our service area. Service Area Bucks, Chester, Delaware, Montgomery, and PhiladelphiaLearn more about the UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plan for Oklahoma. Check eligibility, explore benefits, and enroll today.2019 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO SNP) Location: Oklahoma, Oklahoma Click to see other locations. Plan ID: H5322 - 031 - 0 Click to see other plans. Member Services: 1-844-368-7150 TTY users 711.The UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 13,894 members. There are 309 members enrolled in this plan in Creek, Oklahoma, and 13,829 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings are as ...H5322-030-000 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_H5322_030_000_2023_M Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageMaximum 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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined. Introduction Introduction This directory provides a list of the plan’s network providers. Depending on your plan, you may receive certain covered services from out-of-network providers that participate in Medicare andY0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_EOC_H5322_031_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaThe table below outlines some of the specific plan details for UnitedHealthcare Medicare Advantage plans available in Oklahoma in 2023. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare. Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Canadian, Cleveland, Kingfisher, Lincoln, Logan and Oklahoma Counties 2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details Y0066_ANOC_H5322_031_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 ... UnitedHealthcare Dual Complete® LP (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.The UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) (H5322 - 031) currently has 28,022 members. There are 44 members enrolled in this plan in Greer, Oklahoma, and 27,957 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. 729 Medicare Advantage Plans from Humana. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0028:007-0 Humana Gold Plus SNP-DE H0028-007 (HMO D-SNP) H0028:014-0 Humana Gold Plus H0028-014 (HMO) H0028:015-0 Humana Gold Plus SNP-DE H0028-015 (HMO-POS D-SNP) H0028 ...Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $0.00. Prior Authorization Required for Doctor Specialty Visit. Inpatient hospital care. In-Network: Acute Hospital Services: $0.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Acute Hospital Services. Y0066_ANOC_H5322_031_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_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageTTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL): Learn more about the UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plan for Oklahoma. Check eligibility, explore benefits, and enroll today.Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Service area: Oklahoma - Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan, Caddo, Canadian,Vendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contactingh5322 care improvement plus south central insurance co. h5325 coventry health care of kansas, inc. h5410 healthspring of florida, inc. h5420 h5422 blue cross blue shield healthcare plan of georgia h5425 scan health plan h5427 078 freedom health, inc. h5431 healthsun health plans, inc. h5433 orange county health authority h5447 community first ...Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare - H5322 For 2023, UnitedHealthcare - H5322 received the following Star Ratings from Medicare: Overall Star Rating: 5 stars Health Services Rating: 5 stars Drug Services Rating: 4.5 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... UnitedHealthcare - H5322 For 2023, UnitedHealthcare - H5322 received the following Star Ratings from Medicare: Overall Star Rating: 5 stars Health Services Rating: 5 stars Drug Services Rating: 4.5 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ...CST33015_H5322-031-000 Key contacts for additional benefits Member ID Medicaid Medicare Health Plan (80840): 999-99999-99 Member ID: Member: PCP Name: DR. PROVIDER BROWN PCP Phone: (999)999-9999 Payer ID: 999999999 Group Number: SUBSCRIBER BROWN Rx Bin: 999999 Rx Grp: XXXXXXXX Rx PCN: 9999 Sample ID cards Dental Phone: 1-844-275-8750 Monday ... Cigna Alliance Medicare (HMO) H3949-031 1 Summary of Benefits H3949_23_791509_M Better benefits supported by a dedicated network of providers with no referrals required To Join You must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in our service area. Service Area Bucks, Chester, Delaware, Montgomery, and Philadelphia 2022 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Resources and tools for providers and health care ...UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Social Security Number (Required for people who are enrolling in D-SNP plans): _ _ Medicare Number Permanent Residence Street Address (P.O. Box is not allowed) City County State ZIP Code Mailing Address (Only if it’s different from above. You can give a P.O. Box.) CityNumber of Members enrolled in this plan in (H5322 - 031): 5,075 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 ... o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 ¨ FemeninoH3749-001-000, H3749-017-000, H3749-018-000, H3749-020-000, H8768-008-000, H8768-009-000, H8768-016-000, H8768-028-000, H5322-031-000. NEW 2023: H0271-053-000, H5322-033-000. Texas: Corpus Christi: For WellMed impacted plans, billing instructions, provider eligibility and other details, please reference https://www.wellmedhealthcare.com ...The UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) (H5322 - 031) currently has 28,022 members. There are 44 members enrolled in this plan in Greer, Oklahoma, and 27,957 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.Number of Members enrolled in this plan in (H5322 - 031): 5,075 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 ...2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ...2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5322-031-000 Subject: UnitedHealthcare Dual Complete additional benefit overview for health care professionals. Created Date: 20221229003319ZCST33015_H5322-031-000 Key contacts for additional benefits Member ID Medicaid Medicare Health Plan (80840): 999-99999-99 Member ID: Member: PCP Name: DR. PROVIDER BROWN PCP Phone: (999)999-9999 Payer ID: 999999999 Group Number: SUBSCRIBER BROWN Rx Bin: 999999 Rx Grp: XXXXXXXX Rx PCN: 9999 Sample ID cards Dental Phone: 1-844-275-8750 Monday ...H5322-031-000 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_H5322_031_000_2023_M Summary of BenefitsY0066_ANOC_H5322_031_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 ...CSOK23HP0050808_000 Página 1 de 8 Solicitud de Inscripción 2023 o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Number of Members enrolled in this plan in (H5322 - 031): 5,075 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 ...H5322-031-000, H0271-053-000, H5322-033-000. 2 Table of contents UnitedHealthcare hospice VBID model overview ...UnitedHealthcare - H5322 En el año 2023, UnitedHealthcare - H5322 recibió las siguientes Calificaciones con Estrellas de Medicare: Calificación General por Estrellas: 5 estrellas Calificación de los Servicios de Salud: 5 estrellas Calificación de los Servicios de Medicamentos: 4.5 estrellas Introduction facility that is currently Medicare-approved for your specific type of transplant. The plan’s hospital network for organ transplant services is different than the network shown in the “Hospitals” section 2022 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.H5322-031-000 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 www.UHCCommunityPlan.com Y0066_SB_H5322_031_000_2022_MY0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare offers UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plans for Oklahoma and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 We would like to show you a description here but the site won’t allow us.o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 ¨ Femenino2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ...

UnitedHealthcare offers UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plans for Oklahoma and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. . Vars

h5322 031

TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL): 2022 Summary of Benefits GNHH4HIEN_22_C H5216228000SB22 SBOSB035 HumanaChoice SNP-DE H5216-228 (PPO D-SNP) Oklahoma Select Counties in OklahomaVendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contactingIntroduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areaH5322-031 OK99OKDSNPF OK99OKDSNPP OK99OKDSNPQ UnitedHealthcare Dual ... H5322-033 OK99OKDSNP4F, OK99OKDSNP4P, OK99OKDSNP4Q. 2022 United HealthCare Services Inc. All ...UnitedHealthcare Dual Complete® LP (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. Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2023 Evidence of Coverage for UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Table of Contents Questions? Call Customer Service at 1-866-842-4968, TTY 711, 8am-8pm: 7 Days Oct- Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS)Catastrophic drug coverage limit. $7,400.00. Primary care doctor visit. $0 in-network / $55 out-of-network. Specialty doctor visit. $35 in-network / $60 out-of-network. Inpatient hospital care. $375 per day, days 1-5; $0 per day, days 6-90 in-network / 50% per stay out-of-network. Urgent care.2019 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete (HMO SNP) - H5322-031-0 This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO-POS D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $0.00. Prior Authorization Required for Doctor Specialty Visit. Inpatient hospital care. In-Network: Acute Hospital Services: $0.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Acute Hospital Services. H5322-031-000 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 www.UHCCommunityPlan.com Y0066_SB_H5322_031_000_2022_MY0066_ANOC_H5322_031_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_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageIntroduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areaY0066_ANOC_H5322_031_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 ... CSOK23HP0050808_000 Página 1 de 8 Solicitud de Inscripción 2023 o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) .

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