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How does UnitedHealthcare Dual Complete impact my patients?

Aug 24, 2022, 12:13 PM by UnitedHealthCare
There are many health benefits for individuals who are dual eligible for Medicare and Medicaid, spanning dental, food/nutrition, routine vision and hearing, physical fitness, and more.

Content provided by UnitedHealthcare Community & State District of Columbia

UnitedHealthcare offers a Medicare Advantage plan in the District of Columbia known as UnitedHealthcare Dual Complete® (PPO D-SNP), a Dual Special Needs Plan (D-SNP), for individuals who are eligible for both Medicaid and Medicare.

In 2023, UnitedHealthcare will offer three Medicare Advantage plans in the District of Columbia: UnitedHealthcare Dual Choice, UnitedHealthcare Dual Choice One, UnitedHealthcare Dual Choice Unity. D-SNP eligible enrollees can include low-income individuals and people with disabilities who are 21 and older. Individuals must qualify for Medicaid and Medicare separately. While most qualify for Medicare once they reach 65, some younger adults with disabilities also qualify.

Enrollees can continue to access core Medicare benefits along with Part D (pharmacy) benefits and targeted clinical programs and services. Additionally, the plan offers supplemental benefits and services that are not typically available through Original Medicare or Medicaid at no extra cost. These may include:

Dental coverage
Dental services including emergency care visits, covered exams, cleanings, X-rays, fillings, crowns, bridges, root canals and extractions and dentures

OTC+ Healthy Food
$80 a month on a prepaid card for over-the-counter (OTC) and covered groceries in-store or online

Prescription drug coverage
$0 copay or coinsurance for all covered generic and brand name prescription drugs at a network pharmacy
$0 prescription drug deductible

Routine vision care
$0 copay, 1 routine eye exam every year and 1 pair of standard lenses and frames every year. Standard lenses that are covered in full include single vision, lined bifocal, lined trifocal, lenticular, and Tier I (standard) progressive lenses.
OR
Contact lenses instead of standard lenses and frames every year
AND
$250 allowance toward the purchase of frames (fitting and evaluation may be an additional cost) or contact lenses (fitting and evaluation may be an additional cost).

Routine hearing coverage
$0 copay for a routine hearing exam and coverage for a wide selection of hearing aid styles.

Routine transportation
Enrollees are eligible for $0 copay for 24 one-way rides to or from approved locations, such as medically related appointments, gyms, and pharmacies. Once the 24 visits are utilized, enrollees may be eligible for additional transportation visits to approved locations under their Medicaid Benefit for routine & urgent provider appointments, follow-up visits, hospital discharges and urgent care services.

Renew Active® Fitness Program
Get a free gym membership to participating fitness locations, digital workout videos and live stream classes, access to the Fitbit® Community for Renew Active, an online brain health program from AARP® Staying Sharp®, local classes and events and more.

UnitedHealthcare at Home
The UnitedHealthcare at Home in-home visits support the care our enrollees are already getting from their regular doctors.  A UnitedHealthcare at Home advance practice clinician, such as a nurse practitioner or physician assistant, visits the enrollee in the home.

Personal Emergency Response System (PERS)
 In an emergency, the PERS system quickly connects the enrollee with a trained operator. The operator can give assistance over the phone and send help if needed. PERS is a life-saving benefit that’s available 24 hours a day.