New Mexico UnitedHealthcare Medicare Advantage Plans
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.
- UnitedHealthcare MedicareComplete Assure (PPO)
Health Maintenance Organization (HMO) plans have a defined 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. Some HMO plans do not need referrals for specialty care.
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.
OptumCare New Mexico
Tools and Resources - UnitedHealthcare® Medicare Advantage Plans
- 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 Preventive Screening Guidelines
- Medicare Advantage Service Area Reductions for 2021 Frequently Asked Questions
- 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
- 2020 UnitedHealthcare Medicare National Network – Frequently Asked Questions
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 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.