Page 2 - M-LT-FL20-328 Medicare Advantage Sales Brochure flip book 2020
P. 2
UnitedHealthcare® Medicare Advantage
Choice PPO
Plan Highlights (In-Network)
Monthly plan premium $0
Primary care provider visit $0
Specialist visit $35
Specialist referral required? NO
Lab services $0
Emergency care $90
Annual out-of-pocket maximum $5,900
See any doctor who accepts Medicare PPO Plan
24/7 phone access to a registered nurse
UnitedHealthcare ® HouseCalls 1
Earn $10 per month in rewards for staying active by
tracking your steps.
Over-the-counter benefit $40
Prescription Drugs — Standard Retail (30-day); Preferred Mail Order (90-day)
Tier 1 – Preferred generic drugs 30-day: $0
Tier 2 – Generic drugs 30-day: $8
Tier 3 – Preferred brand drugs 30-day: $45
Tier 4 – Non-preferred drugs 30-day: $95
Tier 5 – Specialty tier drugs 30-day: $33% coinsurance
Annual prescription deductible $0
1 HouseCalls may not be available in all areas.
