An HMO plan vs. a PPO plan, whats the difference | UnitedHealthcare Community Plan: Medicare & Medicaid Health Plans

language line services are available to all providers within the network.

unitedhealthcare senior care options plan (hmo snp)

unitedhealthcare sco is a coordinated care plan with a medicare contract and a contract with the massachusetts community medicaid program. enrollment in the plan is contingent upon renewal of the plan’s contract with medicare. this plan is a voluntary program that is available to anyone age 65 and older who qualifies for masshealth standard and original medicare. If you have Standard MassHealth, but don’t qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Reading: What type of insurance is medicaid hmo or ppo

availability of disclaimer in languages ​​other than English

Please note: If you speak an alternate language, language assistance services are available to you free of charge. call 1-800-905-8671 tty 711, or use your preferred relay service.

Star Ratings Disclaimer

each year, medicare rates plans based on a 5-star rating system.

forms

The formulary, pharmacy network and provider network may change at any time. you will receive a notice when necessary.

ncqa

unitedhealthcare connected® has a model of care approved by the national committee for quality assurance (ncqa) to operate as a special needs plan (snp) through 2017 based on a review of the unitedhealthcare connect model of care.

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important provider information

the choice is yours

We will provide you with information to help you make informed decisions, such as the credentials of physicians and health care professionals. This information, however, does not endorse the suitability of any particular physician or health care professional for her needs.

The providers available through this application may not necessarily reflect the full extent of unitedhealthcare’s network of contracted providers. There may be providers or certain specialties not listed in this application that are part of our network. If you do not find the provider you are looking for, you may contact the provider directly to verify participation status in the unitedhealthcare network or contact customer service at the toll-free number shown on your unitedhealthcare ID card. We also recommend that before you see any doctor, including specialists, you call the doctor’s office to check their participation status and availability.

Some providers may have been added or removed from our network after this directory was updated. we do not guarantee that each provider will continue to accept new members.

Out-of-network or non-contracted providers are under no obligation to treat unitedhealthcare plan members, except in emergency situations. Call our customer service number or see your Evidence of Coverage for more information, including cost sharing that applies to out-of-network services.

U.S. Disabilities Act notice

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In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 (“ADA”), unitedhealthcare insurance company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

references

Network providers help you and your covered family members get the care you need. access to specialists can be arranged by your primary care physician.

paper directory applications

Hard copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. non-members can download and print search results from the online directory.

inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. this email box is for members to report possible inaccuracies in demographic information (address, phone, etc.) in online or print directories. reporting issues through this mailbox will result in a contact to the provider’s office to verify all directory demographics, which may take approximately 30 days. people can also report potential inaccuracies over the phone. unitedhealthcare members should call the number on the back of their ID card, and non-unitedhealthcare members can call 888-638-6613 tty 711, or use their relay service preferred.

declaration of disaster or emergency

If you are affected by a declaration of a disaster or emergency by the president or a governor, or an announcement of a public health emergency by the secretary of health and human services, there is some additional support available to you.

• part a, part b and supplemental part c plan benefits must be provided at specified non-contracting facilities (note that part a and part b benefits must be obtained at medicare certified facilities) );
• where applicable, the requirements for guardian referrals will be waived in full;
• Plan-approved out-of-network cost-sharing amounts to in-network cost-sharing are temporarily reduced; and
• The 30-day notice requirement to members is waived, as long as all changes (such as reduced cost sharing and waiver of authorization) are in the member’s interest.

If cms has not provided an end date for the disaster or emergency, the plans will resume normal operation 30 days after the initial declaration.

Source: https://amajon.asia
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