H0271 060 - 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 ...

 
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H0271-060: Download: UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) 2023: R5342-001: Download: UnitedHealthcare Medicare Advantage Choice Plan 4 ...Y0066_EOC_H0271_060_002_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaTTY 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 ...Number of Members enrolled in this plan in (H0271 - 057): 3,821 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 ...o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - 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 NumberY0066_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 ...Medical Plans. Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc.License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc ...533 Medicare Advantage Plans from UnitedHealthcare. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0271:007-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:012-0 UnitedHealthcare Medicare Advantage Assure (PPO) H0271:017-0 UnitedHealthcare Medicare ...Y0066_SB_H0271_060_001_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 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-001; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-002; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H3387-013-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H3387-014-001; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H3387-014-002We would like to show you a description here but the site won’t allow us. Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Área de servicio: New York - condados de Albany, Allegany, Broome, Cattaraugus, Cayuga,5. Introduction. SHIBA (Senior Health Insurance Benefits Assistance) is a statewide network of certified . counselors volunteering in their community to help all Oregonians make educated Y0066_EOC_H0271_060_001_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_SB_H0271_045_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 ...Jan 1, 2023 · Y0066_SB_H0271_045_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_060_002_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageEnrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 Service area: New York - Bronx, Kings, Nassau, New York, Queens, Richmond countiesh0271-060-002 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan.Monday – Friday 8 a.m. – 6 p.m. EST 1-888-617-8979 TTY 711. To learn more about applying for health insurance, including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.2023 UnitedHealthcare (H0271) Star Rating Details; UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-060-1) Benefits & Contact Info The UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-060-1) in Putnam, NY: CMS MA Region 3 which includes: NY: Star Rating Category & Measures: 2023: 2022: Overall Star Rating: 4: 4Y0066_EOC_H0271_060_002_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura The following UnitedHealthCare plans are accepted at Oak Street Health locations. Plan Name. Effective Year. Benefit Package. Summary. AARP Medicare Advantage. 2023. H1944-024. AARP Medicare Advantage.Y0066_SB_H0271_050_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_SB_H0271_060_001_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 ... Jan 1, 2023 · h0271-060-002 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-002 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals.Number of Members enrolled in this plan in (H0271 - 036): 2,359 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 ...UnitedHealthcare Chronic Complete Assure (PPO C-SNP) 4 out of 5 stars. UnitedHealthcare Chronic Complete Assure (PPO C-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-027. $ 9.80. Monthly Premium.Call (518) 346-2115 for Medicare Advantage, Supplement & Part D Plans in NY MA NJ or FLH0271 - 060 - 2 Click to see other plans. Member Services: 1-800-514-4912 TTY users 711. — Enrollment Options —. Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit details.Plan ID: H0271-060-001. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. New York 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 ... 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 ... H0271-060-001 CMS Rating 4 out of 5 stars. Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. ...Y0066_SB_H0271_060_001_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: H0271-060-001. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. New York 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 ...OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura Sus Beneficios y Servicios de Salud y su Cobertura de Medicame 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 $3000.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO D-SNP) H0271-060-002 plans for New York and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Number of Members enrolled in this plan in (H0271 - 029): 31,066 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 ... o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - 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 NumberOMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura Sus Beneficios y Servicios de Salud y su Cobertura de MedicameTTY 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_060_001_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaResumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Service area: New York - Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung,H0271-022-000 OR Local PPO UnitedHealthcare Medicare Advantage ... H0543-060-000 CA HMO AARP Medicare Advantage SecureHorizons Premier Not SNP Neither Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud queUnitedHealthcare - 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 estrellas 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 ...CSNY23PP0049825_000 Página 1 de 8 Solicitud de Inscripción 2023 o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul)This page features plan details for 2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP) H0271 – 060 – 1 available in Select Counties in Upstate NY. IMPORTANT : This page has been updated with plan and premium data for 2023. 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 ... Call (518) 346-2115 for Medicare Advantage, Supplement & Part D Plans in NY MA NJ or FLo UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - 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 Number2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-002 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals.h0271-043-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan.CSNY23PP0049826_000 Página 1 de 8 Solicitud de Inscripción 2023 o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - UO7 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul)h0271 023 014 ct in me 020 028 mi 029 030 mt 016 sc 037 sd 038 ut 013 wv 042 wy 039 024 h0321 arizona physicians ipa, inc. az h0423 metroplus health plan, inc. h0432 009 h0439 cigna healthcare of georgia, inc. h0473 humana insurance company of kentucky h0482 centene venture company michigan h0524 kaiser foundation hp, inc. ca h0544 blue cross ...Y0066_SB_H0271_013_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 ...o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - 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 NumberH0271 - 060 - 2 Click to see other plans. Member Services: 1-800-514-4912 TTY users 711. — Enrollment Options —. Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit details. Y0066_EOC_H0271_060_001_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura 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): Call (518) 346-2115 for Medicare Advantage, Supplement & Part D Plans in NY MA NJ or FLOMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura Sus Beneficios y Servicios de Salud y su Cobertura de Medicame Y0066_EOC_H0271_060_001_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageH0271-022-000 OR Local PPO UnitedHealthcare Medicare Advantage ... H0543-060-000 CA HMO AARP Medicare Advantage SecureHorizons Premier Not SNP NeitherEnrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Service area: New York - Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung,Jan 1, 2023 · Y0066_SB_H0271_050_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_SB_H0271_060_002_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 ... Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que Number of Members enrolled in this plan in (H0271 - 036): 2,359 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 ...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 ...2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-002 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals. 5. Introduction. SHIBA (Senior Health Insurance Benefits Assistance) is a statewide network of certified . counselors volunteering in their community to help all Oregonians make educatedY0066_SB_H0271_050_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 ...Number of Members enrolled in this plan in (H0271 - 036): 2,359 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 ...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. Y0066_SB_H0271_060_002_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 ...Jan 1, 2023 · h0271-060-001 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. This page features plan details for 2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP) H0271 – 060 – 2 available in Select Counties Downstate NY. IMPORTANT : This page has been updated with plan and premium data for 2023.Monday – Friday 8 a.m. – 6 p.m. EST 1-888-617-8979 TTY 711. To learn more about applying for health insurance, including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777. Y0066_SB_H0271_060_002_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 ...

o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 - 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 Number. Joe phifer

h0271 060

Y0066_EOC_H0271_060_001_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Coberturao UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-001 - 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 NumberY0066_SB_H0271_023_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_060_002_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura 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 estrellas2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-060-002 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals.UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 Lookup Tools plans for New York and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. Plan ID: H0271-060-002. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. New York 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 ...Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-060-002 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que Y0066_EOC_H0271_023_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageNumber of Members enrolled in this plan in (H0271 - 057): 3,821 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 ...H0271-060-002 Service area: New York - Bronx, Kings, Nassau, New York, Queens, Richmond countiesY0066_SB_H0271_060_002_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 ... UnitedHealthcare Chronic Complete Assure (PPO C-SNP) 4 out of 5 stars. UnitedHealthcare Chronic Complete Assure (PPO C-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-027. $ 9.80. Monthly Premium.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):.

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