Texas DSNP Market Overview - The Brokerage · OTC Product Credits Member-facing catalog:...
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Transcript of Texas DSNP Market Overview - The Brokerage · OTC Product Credits Member-facing catalog:...
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
TexasDual Special Needs Plans 2017 Service Area
Texas DSNP Market Overview
Current Footprint
Expansion
Highlights• 8 expansion counties added
• Benefit improvements in all markets
• New plan in the Rio Grande Valley
• Local agency support available
Market Landscape
Estimated Dual Eligibles 673,876
Total Dual Enrollees 125,698
Estimated FFS Eligibles 548,178
Eligibles in Expansion Area 79,769
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4514-001
Plan Type HMO
Service AreaBastrop, Brazoria, Burnet, Caldwell, Fort Bend, Galveston, Harris, Hays, Henderson, Jefferson, Liberty, Montgomery, Polk,
Smith, Travis, Van Zandt, Waller, Williamson and Wood.
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $200/quarter $800/year; annual expiration
Dental $2,500 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 24 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H2228-041
Plan Type HMO
Service Area El Paso
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $250/quarter $1,000/year; annual expiration
Dental $2,500 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 36 one-way rides for health care visits and prescription needs
Fitness Enrollment in the SilverSneakers fitness program
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4527-003
Plan Type HMO
Service Area Hays, Travis, Williamson
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $110/quarter $440/year; annual expiration
Dental $1,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $150 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 60 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4527-004
Plan Type HMO
Service Area Aransas, Kleberg, Nueces, San Patricio
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $55/quarter $220/year; annual expiration
Dental Preventive dental coverage
Vision Annual exam and $300 credit every year for eyewear
Transportation 60 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4527-006
Plan Type HMO
Service Area El Paso
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $80/quarter $320/year; annual expiration
Dental Preventive dental coverage
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $300 credit every two years for hearing devices
Transportation 30 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4527-015
Plan Type HMO
Service Area Cameron, Hidalgo, Willacy
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $100/quarter $440/year; annual expiration
Dental $1,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $225 credit every year for eyewear
Hearing Annual exam and $300 credit every two years for hearing devices
Transportation 60 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4590-020
Plan Type HMO
Service Area Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $175/quarter $700/year; annual expiration
Dental $2,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 24 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4590-022
Plan Type HMO
Service Area Atascosa, Bexar, Comal, Guadalupe, Kendall, Wilson
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $95/quarter $380/year; annual expiration
Dental $2,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $70 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 24 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H4590-033
Plan Type HMO
Service Area Bee, Jim Wells, Kleberg, Nueces, San Patricio
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $150/quarter $600/year; annual expiration
Dental $2,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 24 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H5322-026
Plan Type HMO
Service Area Cameron, Hidalgo, Willacy
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $75/quarter $300/year; annual expiration
Dental $2,000 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 36 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other
limitations and exclusions may apply. Star ratings are current as of July 2016 and are subject to change in October. Confidential property of UnitedHealth Group. For Agent use only.
Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. Rx
usage based on 2016 year to date claims data.
Texas DSNP Benefit Overview
Dual Complete Plans H5322-025
Plan Type HMO
Service Area Hardin, Harrison, McLennan, Orange, Rusk
Premium $0
Additional Benefits
OTC Product Credits Member-facing catalog: $75/quarter $300/year; annual expiration
Dental $1,250 annually; covers exams, x-rays, cleanings, extractions, periodontal services and more
Vision Annual exam and $200 credit every year for eyewear
Hearing Annual exam and $2,000 credit every two years for hearing devices
Transportation 24 one-way rides for health care visits and prescription needs
NurseLine Available 24 hours a day/7 days a week
Improved for 2017 No changes for 2017Degraded for 2017