2024 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): . Lapine s 100 immune globulin 12c

The UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 114 members enrolled in this plan in Craig, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. 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 estrellas2022 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.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) 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: Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 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.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 Plan ID: H5322-031-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Oklahoma Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... 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.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 steps to enroll. 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.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. Plan ID: H5322-031-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Oklahoma Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Alfalfa, Atoka, Beaver, Beckham, Blaine, Caddo, Choctaw, Cimarron, Coal, Comanche ...Llame al número gratuito 1-800-313-0973 (TTY 711). Se encuentran disponibles agentes con licencia del 1 de octubre al 31 de marzo, de 8 a. m. a 8 p. m. , hora local, h5322 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 ...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_MWe would like to show you a description here but the site won’t allow us.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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined. 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):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 ...2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete LP (HMO D-SNP) Location: Tillman, 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. Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Adair, Bryan, Carter, Cherokee, Delaware, Grady, Le Flore, Muskogee, Osage ...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_MCST33015_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 www.UHCCommunityPlan.com Y0066_SB_H5322_031_000_2022_M 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 NumberProvider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Adair, Bryan, Carter, Cherokee, Delaware, Grady, Le Flore, Muskogee, Osage ... 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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Adair, Bryan, Carter, Cherokee, Delaware, Grady, Le Flore, Muskogee, Osage ...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. 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 ...We would like to show you a description here but the site won’t allow us.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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.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_MH5322-031-000 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 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com2023 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-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 Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-030-000 plan for Georgia. Check eligibility, explore benefits, and enroll today. h5322 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 ...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 D-SNP) (H5322 - 031) currently has 23,586 members. There are 315 members enrolled in this plan in Osage, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ...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 ...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.2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Adair, Bryan, Carter, Cherokee, Delaware, Grady, Le Flore, Muskogee, Osage ... 2023 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- 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 ...Plan ID: H5322-031-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Oklahoma Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... 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 ... 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 Oklahoma Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Área de servicio: Oklahoma - condados de Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan,H5322-031-000 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 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com 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.The 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.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 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.Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageThe UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 315 members enrolled in this plan in Osage, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ...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.Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Área de servicio: Oklahoma - condados de Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan,Vendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contacting 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_MLearn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-030-000 plan for Georgia. Check eligibility, explore benefits, and enroll today. 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 ... H5322-031-000 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 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 Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com. Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Área de servicio: Oklahoma - condados de Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan,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. 2023 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- Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-030-000 plan for Georgia. Check eligibility, explore benefits, and enroll today. 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 ¨ FemeninoThe 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. . UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) CMS Rating Medicare What is a dual special needs plan? H5322-031 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. Sep 26, 2022 · 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 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 steps to enroll.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.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 ¨ FemeninoY0066_ANOC_H5322_031_000_2023_SP_M. Y0066_210610_INDOI_C Encuentre las actualizaciones de su plan para el próximo añoProvider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Alfalfa, Atoka, Beaver, Beckham, Blaine, Caddo, Choctaw, Cimarron, Coal, Comanche ... 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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage

Jan 1, 2023 · 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 Benefits . Form 130 u 2022

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.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.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 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.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 NumberUnitedHealthcare - 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 ...Y0066_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 CoberturaH5322-031-000 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 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.comThe 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 ...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. 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 .

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