Medicare Advantage Special Needs Plans (SNPs) insured through UnitedHealthcare are offered to residents of Erickson Retirement Communities. These SNP plans combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional benefits and services designed to meet the unique needs of identified Medicare consumer populations.
Erickson Advantage Champion (HMO-POS SNP) is a Medicare Advantage Chronic Condition SNP that provides specialized benefits and services for Medicare beneficiaries with chronic conditions such as diabetes, heart failure and/or cardiovascular disorders. Members choose their primary care provider (PCP) and may go outside the contracted network for certain health care services - typically at a higher cost.
Erickson Advantage Guardian (HMO-POS SNP) is a Medicare Advantage Institutional SNP that provides specialized benefits and services for Medicare beneficiaries who live in an Erickson nursing home. Members choose their primary care provider (PCP) and may go outside the contracted network for certain health care services - typically at a higher cost.
Health Maintenance Organization (HMO) plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies.
Point of Service (HMO-POS) plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Many POS plans do not require referrals for specialty care.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare.
Tools and Resources - Erickson Advantage® Champion/Guardian Plans
- Medicare Advantage Chiropractic and Acupuncture Coverage – Quick Reference Guide
- Medicare Advantage Copayment Guidelines
- 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 Preventive Screening Guidelines
- Medicare Advantage Service Area Reductions for 2020 Frequently Asked Questions
- 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)
Coverage options may vary depending upon your location. To learn more about a plan in your service area, go to EricksonAdvantage.com.
To learn more about Medicare Part D prescription drug coverage or to access related forms, please review the materials available on EricksonAdvantage.com on the Formulary tab. Scroll toward the bottom of the page to the Erickson Advantage Drug Management section.
Reminder for Special Needs Plan Providers
UnitedHealthcare provides Special Needs Plan (SNP) care providers access to SNP beneficiaries' Health Risk Assessments (HRAs) and Individualized Care Plans (ICPs) in a variety of ways including mailing, faxing, uploading to the Provider Portal or placing Individualized Care Plans in the SNP beneficiary's physical and/or electronic chart.
Care providers should be reviewing the SNP beneficiary's Individualized Care Plans and participating with the SNP Interdisciplinary Care Team to coordinate the beneficiary's care. Special Needs Plan care providers can register online at UHCprovider.com to begin accessing and reviewing SNP beneficiary Individualized Care Plans via the Care Conductor App on Link.