UnitedHealthcare® Special Needs Plans (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.
Chronic Condition SNP plans are designed for consumers diagnosed with chronic conditions such as diabetes, chronic heart failure, and/or cardiovascular disorders. These plans offer benefits in addition to those covered under Original Medicare such as routine dental, vision, hearing, transportation, and routine podiatry services. Consumers must have a qualifying chronic condition to enroll.
- UnitedHealthcare Medicare Gold (Regional PPO)
- UnitedHealthcare Medicare Silver (Regional 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.
Tools and Resources - UnitedHealthcare Medicare Silver/Gold Plans
- Chronic Condition Verification Form
- HouseCalls Program Overview
- Medicare Advantage Chiropractic and Acupuncture Coverage – Quick Reference Guide
- Medicare Advantage Copayment Guidelines
- 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 Preventive Screening Guidelines
- Medicare Advantage Service Area Reductions for 2021 Frequently Asked Questions
- Readmission Review Program Clinical Guidelines
- Readmission Review Program Frequently Asked Questions
- Special Needs Plans (SNP) Benefit Plan Name Overview
- UnitedHealthcare Administrative Guide
- Medicare Advantage Drug Formulary - UHCMedicareSolutions.com (enter zipcode and select plan)
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.)
Additional Plan Information
To learn more about the Medicare Advantage plans offered in your area, visit UHCMedicareSolutions.com and enter your ZIP code. To learn more about Dual Complete Plans, visit uhccommunityplan.com/dsnp-plans.
Medicare Part D Information
To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on UHCMedicareSolutions.com under Our Plans > Medicare Advantage Plans > What Do I Need to Know? > Medicare Advantage Plan Information and Forms.
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.