5

5 out of 5 stars* for plan year 2024

Plan ID: H6528-006

What You Need to Know:

  • UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is $275 (Tier 1 and 2 excluded from the Deductible.).
  • The plan includes an out-of-pocket maximum of $6,700 per year (in-network).
  • UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $275 (Tier 1 and 2 excluded from the Deductible.).
  • This plan's Part D Initial Coverage Limit is $0.

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 $0 $0 $0 $0 $275.0 1.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H6528-031
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $6,700
Annual Deductible: $275 (Tier 1 and 2 excluded from the Deductible.)
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Dawson, Georgia: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
75 members 3.5 out of 5 Stars. 5 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,668 drugs
Number of Members Enrolled in this Plan in Dawson, Georgia: 12,653 members
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$0.00 $0.00 $0.00 $0.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
303 $4.00 679 $12.00 870 $47.00 1015 $100.00 801 28%

Other Medicare Advantage Plans in Dawson, Georgia

Plan Name Type Premium MOOP Rx Deduct. Rating
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
AARP Medicare Advantage Plus Plan 1 (HMO-POS) (2023)Local HMO$6,700$275
5
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$6,700$150
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UnitedHealthcare Medicare Advantage Patriot (Regional PPO (2023)Regional PPO *$6,700$-
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HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
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AARP Medicare Advantage Plus Plan 2 (HMO-POS) (2023)Local HMO$4,900$175
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Clear Spring Health Select (HMO) (2023)Local HMO$7,550$0
Insufficient data to rate this plan.
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
Cigna True Choice Medicare (PPO) (2023)Local PPO$7,200$195
New plan - not yet rated.
Aetna Medicare Essential Plan (PPO) (2023)Local PPO$6,900$195
5
Clear Spring Health Choice Plan (PPO) (2023)Local PPO$7,550$250
Insufficient data to rate this plan.
Clear Spring Health Select Plus (HMO) (2023)Local HMO$7,550$0
Insufficient data to rate this plan.
Aetna Medicare Value Plus Plan (PPO) (2023)Local PPO$7,550$195
5
CareSource Advantage (HMO) (2023)Local HMO$4,600$30
New plan - not yet rated.
UnitedHealthcare Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5
CareSource Advantage Zero Premium (HMO) (2023)Local HMO$6,700$100
New plan - not yet rated.
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
Anthem MediBlue Access (PPO) (2023)Local PPO$5,900$95
4
HumanaChoice H5216-203 (PPO) (2023)Local PPO$7,550$0
4
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4
Clover Health Choice Value (PPO) (2023)Local PPO$7,550$445
4
Cigna Preferred Medicare (HMO) (2023)Local HMO$6,450$95
4
Aetna Medicare Plus Plan (PPO) (2023)Local PPO$7,550$400
New plan - not yet rated.
HumanaChoice H5216-073 (PPO) (2023)Local PPO$6,700$360
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$6,900$-
New plan - not yet rated.
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Clover Health Choice (PPO) (2023)Local PPO$7,550$0
4
Cigna Preferred GA Medicare (HMO) (2023)Local HMO$7,500$300
4
Medicare Advantage Plans by UnitedHealthcare
AARP Medicare Advantage Plus Plan 1 (HMO-POS) (2023)Local HMO$6,700$275
5
UnitedHealthcare Medicare Advantage Patriot (Regional PPO (2023)Regional PPO *$6,700$-
5
AARP Medicare Advantage Plus Plan 2 (HMO-POS) (2023)Local HMO$4,900$175
5
UnitedHealthcare Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5

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