Effective January 1, 2020, UnitedHealthcare Community Plan of Michigan will offer its Dual Special Needs Plans (DSNP) – UnitedHealthcare Dual Complete, in the following counties: Allegan, Antrim, Arenac, Barry, Bay, Benzie, Berrien, Branch, Calhoun, Cass, Clare, Crawford, Grand Traverse, Gratiot, Hillsdale, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Livingston, Manistee, Mecosta, Missaukee, Montcalm, Newaygo, Ogemaw, Osceola, Otsego, Ottawa, Roscommon, Saginaw, Sanilac, St. Joseph, Tuscola, Van Buren, Washtenaw, Wayne and Wexford counties.
2020 Health Plans include:
*For specifics on geographical areas served by each plan, reference the Frequently Asked Questions underneath the Quick Reference and Overview section.
Health Maintenance Organization (HMO) plans use a 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 require referrals for specialty care.
Point of Service (HMO-POS) plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. POS plans do not require referrals for specialty care.
Preferred Provider Organization (PPO) plans work with a network of contracted local physicians and hospitals, but also allows members 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.
UnitedHealthcare Medicare Advantage Special Needs Plans (SNPs) combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional features and benefits designed to meet the unique needs of identified Medicare consumer populations.
UnitedHealthcare Dual Complete product offerings and state-specific administrative materials are available at UHCCommunityPlan.com > For Health Care Professionals > Michigan.
To learn more about UnitedHealthcare Medicare Advantage plans offered in your area, please visit UHCMedicareSolutions.com and enter your ZIP code.
To learn more about Medicare Part D prescription drug coverage or to access related forms, please 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.
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 Tool on Link.