Beginning 1/1/2021, information about the Piedmont Medicare Choice plans can be found below. Members will receive updated ID cards reflecting plan changes. Please note: Effective 1/1/2021, OptumRx will be the pharmacy benefits manager for these plans. CVS Caremark Pharmacy information pertaining to dates of service through 12/31/2020 can be found on the Virginia Piedmont Plans page, under “Part D Prescription Drug Forms and Resources".
The UnitedHealthcare Medicare Advantage plans cover features and benefits in addition to those included in Original Medicare. Members in some areas may have different plans from which to choose. The plans often include an integrated Medicare Part D prescription drug benefit.
New Plan Names for 2021
The plan names for 2021 are:
- UnitedHealthcare Medicare Advantage Choice Plan One (PPO)
- UnitedHealthcare Medicare Advantage Choice Plan Two (PPO)
Preferred Provider Organization (PPO) plans offer members access to a network of contracted physicians and hospitals, but also allow them the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Members do not need a referral for specialty care.
PPO plans are available as either local PPO (certain counties within a state) or regional PPO (RPPO) offerings. RPPOs serve a larger geographic area - either a single state or a multi-state area. RPPOs offer the same premiums, benefits and cost-sharing requirements to all members in the region.
Other UnitedHealthcare Medicare Advantage plans are available in this area, separate from the UnitedHealthcare Medicare Advantage Choice Plans (formerly Piedmont Community Medicare Select Health Plans). These plans have UnitedHealthcare or AARP branding. You may continue to see these members as usual, as there are no changes occurring with these other plans.
Tools and Resources
- HouseCalls Program Overview
- Medicare Advantage Plans - Benefit Plan Name Overview
- Medicare Advantage Chiropractic and Acupuncture Coverage – Quick Reference Guide
- Medicare Advantage Copayment Guidelines
- Medicare Advantage Durable Medical Equipment (DME) Frequently Asked Questions
- Medicare Advantage Home Health Services Frequently Asked Questions
- Medicare Advantage Member Rights and Responsibilities
- Medicare Advantage Non-Contracted Provider Dispute and Appeal Rights
- Medicare Advantage Non-Contracted Provider Claim Payment Dispute Request Form
- Medicare Advantage Service Area Reductions for 2021 Frequently Asked Questions
- Medicare Advantage Preventive Screening Guidelines
- Optum Behavioral Health Referral Process
- Readmission Review Program Clinical Guidelines
- Readmission Review Program Frequently Asked Questions
- UnitedHealthcare Administrative Guide
- Medicare Advantage Drug Formulary - UHCMedicareSolutions.com (enter zipcode and select plan)
- 2021 UnitedHealthcare Hearing - Quick Reference Guide
UnitedHealthcare Medicare National Network (Note: The National Network is not available in all plans. Please check the front of the member ID card for the National Network logo to verify that a plan has National Network. Members with the National Network will not need to activate Passport.)
- 2021 UnitedHealthcare Medicare National Network – Frequently Asked Questions
- 2021 UnitedHealthcare Medicare National Network – Quick Reference Guide
UnitedHealth Passport® Travel Benefit (Note: UnitedHealth Passport is not available in all plans. Please check the front of the member ID card for the Passport logo to verify that a plan has Passport.)
Additional Medicare Advantage Plan Information
To learn more about the Medicare Advantage plans offered in your area, visit UHCMedicareSolutions.com and enter your ZIP code.
Medicare Part D Information
To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on the Plan Information and Forms page of UHCMedicareSolutions.com.