Number of Members enrolled in this plan in (H0271 - 027): 4,053 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-0002023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.Y0066_SB_H0271_006_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL): The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.Jan 1, 2023 · Y0066_SB_H0271_027_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHC.com/Medicare Y0066_SB_H0271_046_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for a complete list of covered services, limitations and exclusions. Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHC.com/Medicare Y0066_SB_H0271_046_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for a complete list of covered services, limitations and exclusions. UnitedHealthcare - H0271 En el año 2023, UnitedHealthcare - H0271 recibió las siguientes Calificaciones con Estrellas de Medicare: Calificación General por Estrellas: 4 estrellas Calificación de los Servicios de Salud: 3.5 estrellas Calificación de los Servicios de Medicamentos: 3 estrellasY0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Health Plans Colorado 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) CMS Rating Medicare What is a dual special needs plan? H0271-046 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Y0066_EOC_H0271_046_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaUnitedHealthcare offers UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-046-000 plans for Colorado and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ... Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...Jan 1, 2023 · Summary of Benefits 2023 UnitedHealthcare® Chronic Complete Assure (PPO C-SNP) H0271-043-000 Look inside to take advantage of the health services and drug coverages the plan provides. Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined.Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... Y0066_SB_H0271_006_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear Creek, Conejos, Costilla, Crowley, Custer, Denver, Douglas, El Paso, Elbert, Fremont, Gilpin, Grand, Huerfano, Jefferson, Lake, Larimer, Las Animas, Lincoln, Logan, Morgan, Otero, Park, Pueblo, Teller, Washington, Weld countiesLearn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today.Navigate to the CMS Enterprise Portal public home page. Login using your user ID and password. The CMS Enterprise Portal My Portal page is displayed, as shown in Figure 59: My Portal Page – My Profile Drop-down. Select the down arrow icon that appears next to your name at the top of page. Then select My Profile from the drop-down list to ...Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $1000.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, The average monthly premium for Medicare Advantage plans in Denver is $13.91 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Denver County have an average Medicare Star Rating of 3.78 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare ...Y0066_EOC_H0271_016_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-046. $ 0.00.Plan ID: H0271-046-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Colorado Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... Jan 1, 2023 · Y0066_SB_H0271_005_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... 2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Jan 1, 2023 · Y0066_SB_H0271_036_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ... TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ...2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Choice (PPO D-SNP) Location: Denver, Colorado Click to see other locations. Plan ID: H0271 - 046 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ...Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL):Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageTTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL):2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date.UnitedHealthcare Dual Complete Choice (PPO D-SNP) 4 out of 5 stars* for plan year 2023. UnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare.UnitedHealthcare offers UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-046-000 plans for Colorado and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply. Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_EOC_H0271_046_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Medicare Advantage Plan Benefit Details in Plain Text. The following Medicare Advantage plan benefits apply to the UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271 - 046) in Denver, Colorado . This plan is administered by CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO..Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageJan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear 2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-0002023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State.2023 Colorado UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: Plan H0271-046-000 Subject: UnitedHealthcare Community Plan of Colorado manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Please make sure to always validate eligibility and benefits before providing service.o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 Information about you (Please type or print in black or blue ink) Last Name First Name Middle Initial Birth Date Sex ¨ Male ¨ Female Home Phone Number ( ) - Mobile Phone Number ( ) - Social Security NumberTTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL):Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Home Medicare Medicare Plans UnitedHealthcare Dual Complete Choice (PPO D-SNP) UnitedHealthcare Dual Complete Choice (PPO D-SNP) 4 out of 5 stars UnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-046. $ 0.00 Monthly Premium Colorado Counties Served 28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 287Jan 1, 2023 · Y0066_SB_H0271_016_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...
Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage . Results of last night
28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 287UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 stars Every year, Medicare evaluates plans based on a 5-star rating system. Why Star Ratings are Important Medicare rates plans on their health and ... 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-000 H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear Creek, Conejos, Costilla, Crowley, Custer, Denver, Douglas, El Paso, Elbert, Fremont, Gilpin, Grand, Huerfano, Jefferson, Lake, Larimer, Las Animas, Lincoln, Logan, Morgan, Otero, Park, Pueblo, Teller, Washington, Weld countiesY0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Choice (PPO D-SNP) Location: Denver, Colorado Click to see other locations. Plan ID: H0271 - 046 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 Colorado UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: Plan H0271-046-000 Subject: UnitedHealthcare Community Plan of Colorado manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Please make sure to always validate eligibility and benefits before providing service.2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Balance (PPO D-SNP) Location: Litchfield, Connecticut Click to see other locations. Plan ID: H0271 - 059 - 0 Click to see other plans. Member Services: 1-866-272-1967 TTY users 711.Y0066_SB_H0271_006_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...Specialty doctor visit. $40 in-network / $50 out-of-network. Inpatient hospital care. $300 per day, days 1-7; $0 per day, days 8-90 in-network / 50% per stay out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $60.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $110.00.Y0066_SB_H0271_036_000_2023_M. Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of ...2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (PPO D-SNP) Location: Kanawha, West Virginia Click to see other locations. Plan ID: H0271 - 013 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. Specialty doctor visit. $40 in-network / $50 out-of-network. Inpatient hospital care. $300 per day, days 1-7; $0 per day, days 8-90 in-network / 50% per stay out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $60.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $110.00..
