H5322 025 02 - hmopos

What is a dual special needs plan?

These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams. Members must have Medicaid to enroll. Health Maintenance Organization HMO plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care. Point of Service HMO-POS plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Some POS plans only cover out-of-network dental care.

H5322 025 02 - hmopos

We're dedicated to improving your health and well-being. Members have access to specialized behavioral health services, which includes mental health and may include substance use treatment. Coverage services may vary based on eligibility. Search for providers, clinics and treatment centers. This search option is only available for desktop users. Note that you can download a list of covered drugs below. Search for drugs covered by our plan. If we make a coverage decision and you are not satisfied with this decision, you can "appeal" the decision. An appeal is a formal way of asking us to review and change a coverage decision we have made. What to do if your current prescription drugs are not on the Drug List formulary or are restricted in some way.

Your health care needs are unique. English Opens in a new tab PDF 4.

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We're dedicated to improving your health and well-being. Members have access to specialized behavioral health services, which includes mental health and may include substance use treatment. Coverage services may vary based on eligibility. Search for providers, clinics and treatment centers. This search option is only available for desktop users. Note that you can download a list of covered drugs below. Search for drugs covered by our plan. If we make a coverage decision and you are not satisfied with this decision, you can "appeal" the decision.

H5322 025 02 - hmopos

Learn more about Texas Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price. The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage. The following vision services are covered, though there may be provider network restrictions. The following hearing services are covered, though there may be provider network restrictions. The following services are covered, though there may be provider network restrictions.

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You must get your 1-month supply, as described in EOC, during the first 90 days of membership with the plan as a new member OR within the first 90 days of the calendar year if you are a continuing member and your drug has encountered a negative formulary change. Update Now. If you are prescribed a drug that is not on our formulary or your ability to get your drugs is restricted in some way, you are required to use the plan's exception process. It takes about 30 minutes. Share this page by email Print this page Close modal. Find providers and coverage for this plan. Learn more about dual special needs plans. Hmm … it looks like your browser is out of date. Some POS plans only cover out-of-network dental care. Learn more about dual special needs plans. To Email. Nurse Hotline Talk to a registered nurse about your health-related questions or concerns anytime, day or night at no cost.

What is a dual special needs plan? If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan.

If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan. Search for drugs covered by our plan. There may be unplanned transitions such as hospital discharges or level of care changes i. Talk to a registered nurse about your health-related questions or concerns anytime, day or night at no cost. Laptop Icon. Nurse Hotline Talk to a registered nurse about your health-related questions or concerns anytime, day or night at no cost. Preferred Provider Organization PPO plans work with a network of contracted local physicians and hospitals, but also allows members the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Tooth Icon. For help scheduling an appointment, call the toll-free number on the back of your member ID card. Is this plan available in my county? As a UnitedHealthcare member, earn rewards for getting an annual wellness visit, flu shot, and more. If we make a coverage decision and you are not satisfied with this decision, you can "appeal" the decision. Learn More. Behavioral Health We're dedicated to improving your health and well-being. What to do if your current prescription drugs are not on the Drug List formulary or are restricted in some way.