Medicare
What is a dual special needs plan?
H6595-003 -000
Monthly premium: $0.00 *
*Your costs may be as low as $0, depending on your level of Extra Help.
Our plan is a Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization) with a Point-of-Service (POS) option approved by Medicare and run by a private company. “Point-of-Service” means you can use providers outside the plan’s network for an additional cost.
This plan is available in the following counties:
Adair, Allen, Anderson, Ballard, Barren, Bath, Bell, Boone, Bourbon, Boyd, Boyle, Bracken, Breathitt, Breckinridge, Bullitt, Butler, Caldwell, Calloway, Campbell, Carlisle, Carroll, Carter, Casey, Christian, Clark, Clay, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Elliott, Estill, Fayette, Fleming, Floyd, Franklin, Fulton, Gallatin, Garrard, Grant, Graves, Grayson, Green, Greenup, Hanco*ck, Hardin, Harlan, Harrison, Hart, Henderson, Henry, Hickman, Hopkins, Jackson, Jefferson, Jessamine, Johnson, Kenton, Knott, Knox, Larue, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, Livingston, Logan, Lyon, Madison, Magoffin, Marion, Marshall, Martin, Mason, McCracken, McCreary, McLean, Meade, Menifee, Mercer, Metcalfe, Monroe, Montgomery, Morgan, Muhlenberg, Nelson, Nicholas, Ohio, Oldham, Owen, Owsley, Pendleton, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan, Russell, Scott, Shelby, Simpson, Spencer, Taylor, Todd, Trigg, Trimble, Union, Warren, Washington, Wayne, Webster, Whitley, Wolfe, and Woodford.
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Special eligibility requirements
If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan.
Do you qualify for state Medicaid benefits?
- You must be eligible for Medicare and have full or partial Medicaid coverage in one of the following categories:FBDE, QDWI, QI, QMB, QMB PLUS, SLMB, SLMB PLUS
Do you have Medicare Parts A and B?
You are eligible for Original Medicare (Parts A and B) if:
- You're at least 65 years old, or you're under 65 and qualify on the basis of disability or other special situation.
AND
- You're a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years.
Do you live in the Plan’s service area?
- A UnitedHealthcare representative can confirm if you live in the service area.
Are you 65 years or older but don’t qualify? Find Medicare Advantage, Medicare Supplement or Prescription Drug Plans at uhc.com/medicare
1-844-812-5967 TTY: 711 8:00 am to 8:00 pm local time, 7 days a week
Find providers and coverage for this plan.
Find a Provider
Search for doctors, hospitals, and specialists.
Find Behavioral Health Support
Search for providers, clinics and treatment centers.
Find a Pharmacy
Find a pharmacy near you.
View Drug List
Find medications covered by this plan.
Benefits & Features
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$68 credit every month to pay for healthy food, OTC products and utility billsLearn more about this benefit
$1000dental allowance for covered preventive and comprehensive services like cleanings, fillings and crowns
$0copay for generic and brand-name prescriptions including Optum® Home DeliveryLearn more about this benefit
$0 copay for 24one-way rides to or from approved medically related appointments and pharmacies to get prescriptions
$0 copay for a routine eye exam and$250 allowance for frames or contactsLearn more about this benefit
See More Benefits and Features
Meal Delivery
28 home-delivered meals for 14 days after every inpatient hospital stay
Nurse Hotline
Talk to a registered nurse about your health-related questions or concerns anytime, day or night at no cost
Personal emergency response system (PERS)
Wearable emergency device to get help 24 hours a day
Preventive care
$0copay for preventive care, including an annual physical, flu shot, screenings and more
Primary care visits
$0copay for primary care visits to help you get the care you need
Renew Active® and Fitbit®
Free gym membership through Renew Active® and free Fitbit® to help you reach your health and fitness goals
Routine chiropractic services
12routine chiropractic visits for a$0 copay each visit to treat nausea or pain in your nerves, muscles or joints
Routine foot care
8routine foot care visits for a$25 copay each visit for nail trims and other covered preventive care treatments
Routine hearing benefits
$0 copay for routine hearing exam and $1100 allowance for a broad selection of OTC and brand-name hearing aidsLearn more about this benefit
UnitedHealthcare® HouseCalls
Yearly in-home visit with a health care practitioner to help stay on top of your health between regular doctor visits
UnitedHealthcare® Member Rewards
As a UnitedHealthcare member, earn rewards for getting an annual wellness visit, flu shot, and more
Virtual visits
$0 copay for virtual visits to talk about medical and mental health concerns from home
UHC Dual Complete KY-S002 (HMO-POS D-SNP)
Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs
If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.
This table shows you what your monthly plan premium will be if you get extra help.
| Your level of extra help | Monthly Premium* |
|---|---|
| 100% | $0.00 |
*This does not include any Medicare Part B premium you may have to pay.
If you aren’t getting extra help, you can see if you qualify by calling:
- 1-800-Medicare or TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
- Your State Medicaid Office, or
- The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.
Your health care needs are unique. These documents can help you make sure you get the right coverage.
Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary of Benefits, Other downloadable resources.
Downloadable Resources (opens modal window)
Downloadable Resources
UHC Dual Complete KY-V001 (HMO-POS D-SNP)
Annual Notice of Changes
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English (Opens in new window)
PDF 1.05MB - Last Updated: 09/23/2023
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Español (Spanish) (Se abre en una ventana nueva)
PDF 1.06MB - Last Updated: 09/23/2023
Enrollment Application
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English (Opens in new window)
PDF 59.95KB - Last Updated: 09/15/2023
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Español (Spanish) (Se abre en una ventana nueva)
PDF 62.59KB - Last Updated: 09/15/2023
Enrollment Kit
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English (Opens in new window)
PDF 3.35MB - Last Updated: 12/12/2023
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Español (Spanish) (Se abre en una ventana nueva)
PDF 3.28MB - Last Updated: 12/12/2023
Evidence of Coverage
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English (Opens in new window)
PDF 1.03MB - Last Updated: 05/07/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 1.21MB - Last Updated: 05/07/2024
Formularies
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English (Opens in new window)
PDF 963.44KB - Last Updated: 06/01/2024
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Step Therapy Criteria - English (Opens in new window)
PDF 56.93KB - Last Updated: 06/01/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 531.64KB - Last Updated: 06/01/2024
Medicare Plan Star Ratings
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English (Opens in new window)
PDF 498.08KB - Last Updated: 10/23/2023
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Español (Spanish) (Se abre en una ventana nueva)
PDF 357.12KB - Last Updated: 10/23/2023
Pre-Enrollment Checklist
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English (Opens in new window)
PDF 145.76KB - Last Updated: 01/03/2024
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Español (Se abre en una ventana nueva)
PDF 198.90KB - Last Updated: 01/03/2024
Provider Directories
Adair, Allen, Anderson, Ballard, Barren, Bath, Bell, Boone, Bourbon, Boyd, Boyle, Bracken, Breathitt, Breckinridge, Bullitt, Butler, Caldwell, Calloway, Campbell, Carlisle, Carroll, Carter, Casey, Christian, Clark, Clay, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Elliott, Estill, Fayette, Fleming, Floyd, Franklin, Fulton, Gallatin, Garrard, Grant, Graves, Grayson, Green, Greenup, Hanco*ck, Hardin, Harlan, Harrison, Hart, Henderson, Henry, Hickman, Hopkins, Jackson, Jefferson, Jessamine, Johnson, Kenton, Knott, Knox, Larue, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, Livingston, Logan, Lyon, Madison, Magoffin, Marion, Marshall, Martin, Mason, McCracken, McCreary, McLean, Meade, Menifee, Mercer, Metcalfe, Monroe, Montgomery, Morgan, Muhlenberg, Nelson, Nicholas, Ohio, Oldham, Owen, Owsley, Pendleton, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan, Russell, Scott, Shelby, Simpson, Spencer, Taylor, Todd, Trigg, Trimble, Union, Warren, Washington, Wayne, Webster, Whitley, Wolfe and Woodford counties
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English (Opens in new window)
PDF 21.05MB - Last Updated: 05/15/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 21.58MB - Last Updated: 05/15/2024
Summary of Benefits
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English (Opens in new window)
PDF 76.63KB - Last Updated: 05/30/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 85.56KB - Last Updated: 05/30/2024
Vendor Information
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English (Opens in new window)
PDF 33.61KB - Last Updated: 09/22/2023
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Español (Spanish) (Se abre en una ventana nueva)
PDF 34.99KB - Last Updated: 09/22/2023
Member Resources
View Available Resources (opens modal window)
Member Resources
UHC Dual Complete KY-V001 (HMO-POS D-SNP)
Flu Shots
Influenza is a serious illness that can be easily prevented by a simple shot.
- The best time to get a flu shot is before flu season starts. Talk to your doctor about what is right for you. You may want to write down when you get your shot, and plan to get it at the same time each year.
- When you get your flu shot, it is covered by the terms of your plan. For help scheduling an appointment, call the toll-free number on the back of your member ID card. Health coaches are available daily from 8 a.m. – 8 p.m. to help you.
Don't have time to see the doctor for a flu shot? View alist of locations where you can get a flu shot.
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Flu Shot Locations (Opens in new window)
PDF 79.42KB - Last Updated: 04/21/2023
Provider Directories
Adair, Allen, Anderson, Ballard, Barren, Bath, Bell, Boone, Bourbon, Boyd, Boyle, Bracken, Breathitt, Breckinridge, Bullitt, Butler, Caldwell, Calloway, Campbell, Carlisle, Carroll, Carter, Casey, Christian, Clark, Clay, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Elliott, Estill, Fayette, Fleming, Floyd, Franklin, Fulton, Gallatin, Garrard, Grant, Graves, Grayson, Green, Greenup, Hanco*ck, Hardin, Harlan, Harrison, Hart, Henderson, Henry, Hickman, Hopkins, Jackson, Jefferson, Jessamine, Johnson, Kenton, Knott, Knox, Larue, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, Livingston, Logan, Lyon, Madison, Magoffin, Marion, Marshall, Martin, Mason, McCracken, McCreary, McLean, Meade, Menifee, Mercer, Metcalfe, Monroe, Montgomery, Morgan, Muhlenberg, Nelson, Nicholas, Ohio, Oldham, Owen, Owsley, Pendleton, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan, Russell, Scott, Shelby, Simpson, Spencer, Taylor, Todd, Trigg, Trimble, Union, Warren, Washington, Wayne, Webster, Whitley, Wolfe and Woodford counties
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English (Opens in new window)
PDF 21.05MB - Last Updated: 05/15/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 21.58MB - Last Updated: 05/15/2024
Summary of Benefits
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English (Opens in new window)
PDF 76.63KB - Last Updated: 05/30/2024
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Español (Spanish) (Se abre en una ventana nueva)
PDF 85.56KB - Last Updated: 05/30/2024
Learn more about dual special needs plans
- Benefits
- Eligibility
- Enrollment
- FAQ's
- Caregiver
Learn More
UHC Dual Complete KY-S002 (HMO-POS D-SNP)
- About Medicare (Opens in a New Tab)
- Appeals and Grievances Process
- Frequently Asked Questions
- Fighting Healthcare Fraud (Opens in a New Tab)
- Glossary of Terms
- Medicare Part D (Opens in a New Tab)
- Medicare Advantage Eligibility
- Steps to Enroll
- Helpful Links
- Plan Information and Forms
