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Dual Plans 101: UnitedHealthcare Dual Complete Plan Can Bring Additional Benefits,

Monday, October 14, 2019   (0 Comments)
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Dual Plans 101: UnitedHealthcare Dual Complete Plan Can Bring Additional Benefits, Convenience to Low-Income Seniors and People with Disabilities

 
If you interact with people eligible for both Medicare and Medicaid, you should know about an option that could offer a convenient approach to managing their health care.


What’s a Dual-Eligible Special Needs Plan (DSNP)?


Most of us have heard of Medicare and Medicaid. Medicare provides health benefits for people over age 65 as well as people younger than 65 who qualify due to a disability. Medicaid provides health benefits for people with low income, though eligibility criteria vary by state.


A UnitedHealthcare Dual Complete plan is a DSNP that provides health benefits for people who are “dually-eligible,” meaning they qualify for both Medicare and Medicaid.


Who qualifies?

 
Anyone who meets the eligibility criteria for both Medicare and Medicaid is qualified to enroll in a DSNP. They often face unique health needs and could use assistance improving their health and quality of life. For instance they may:

  • Have a disabling condition and struggle with daily activities such as bathing and dressing;
  • Suffer from a cognitive impairment or a mental disorder;
  • Receive care from multiple doctors to manage a variety of health conditions; or
  • Be more likely to need in-home care providers or other health and social services.


In Washington state, an estimated 166,000 individuals are eligible for DSNP and only 23% of eligible individuals are currently enrolled in a DSNP. 


Why should someone consider a Dual Complete plan?

 
Medicare and Medicaid are important sources of health care benefits for millions of Americans, but the programs can be confusing and tough to navigate. This is especially true for people eligible for both programs. By coordinating Medicare and Medicaid benefits, a Dual Complete plan can make it simpler for members to navigate the health care system. This plan encourages everyone involved in caring for a member – including primary care doctors, specialists, hospitals and care managers – to work together, which can help improve members’ health as well as their experience with the health care system.

 

In Washington state, a UnitedHealthcare Dual Complete plan offers additional benefits. In 2020, these benefits will include:

  • $3,000 in dental care credits each year covering regular exams,  x-rays, fillings, crowns, root canals, dentures and extractions;
  • $1,100 in credits to purchase  approved over-the-counter health products via a catalog, online or in retail locations;
  • Hearing exams and credits for hearing aids;
  • A bi-annual eye exam and a credit for eyewear; and
  • Access to fitness locations at no additional cost;
  • 4 podiatry visits per year;
  • 48 one-way transportation to health care visits and the pharmacy;
  • 20 annual Acupuncture and Chiropractic visits with no copay;
  • 24/7 NurseLine for quick access to care.


And an added bonus: People who are eligible for a Dual Complete plan usually can enroll for no monthly premium, making it an affordable option.

When can people apply?

 
Open enrollment is a great time to consider a DSNP, as health plan benefits are often top of mind for consumers. However, people who are eligible for a DSNP can enroll or switch to a new plan at certain times during the year, not just during the Annual Enrollment Period.


How can someone learn more about DSNP?

 
To find out if a DSNP is available in their area, people can visit www.uhccp.com/wa.  


Trained insurance counselors through the State Health Insurance Assistance Program (SHIP) can help walk through specific plan options. Or, people can reach out to a licensed insurance agent in their area who can meet in person or over the phone to determine whether a DSNP is a good fit. 


UnitedHealthcare is the largest provider of Medicare Advantage plans, including DSNP, serving nearly 4.4 million people.ii To learn more about UnitedHealthcare’s Dual Complete plan, visit GetDual.com.

 


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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare and a contract with the State Medicaid Program. This plan is available to anyone who has both Medical Assistance from the State and Medicare.

 

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Premiums, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Enrollees have no out of pocket costs.

 

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i CMS enrollment data, 2017
ii UnitedHealthcare and CMS enrollment data, 2017

 

 

 

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