4 out of 5 stars* for plan year 2022
$29.10 Monthly Premium
UnitedHealthcare Medicare Advantage Assure (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: H0271-004-000
$29.10 Monthly Premium
Illinois 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 and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Illinois Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
Coverage | Details |
---|---|
Monthly plan premium | $29.10 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $480.00 |
Out-of-pocket maximum | $7,550.00 |
Initial drug coverage limit | $4,430.00 |
Catastrophic drug coverage limit | $7,050.00 |
Primary care doctor visit | In-Network: Doctor Office Visit: |
Specialty doctor visit | Out-of-Network: Doctor Specialty Visit: |
Inpatient hospital care | In-Network: Acute Hospital Services: |
Urgent care | Urgent Care: Copayment for Urgent Care $65.00 Worldwide Coverage: |
Emergency room visit | Emergency Care: Copayment for Emergency Care $90.00 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours Worldwide Coverage: |
Ambulance transportation | In-Network: Ground Ambulance: Air Ambulance: Section B - General 10a Note - NOTE ON AUTHORIZATION: Authorization is required for Non-emergency Medicare-covered ambulance ground and air transportation. Emergency Ambulance does not require authorization. |
Health Care Services and Medical Supplies
UnitedHealthcare Medicare Advantage Assure (PPO) covers a range of additional benefits. Learn more about UnitedHealthcare Medicare Advantage Assure (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage | Details |
---|---|
Chiropractic services | In-Network: Chiropractic Services: |
Diabetes supplies, training, nutrition therapy and monitoring | Out-of-Network: Diabetic Supplies and Services: |
Durable medical equipment (DME) | Out-of-Network: Durable Medical Equipment: |
Diagnostic tests, lab and radiology services, and X-rays | Out-of-Network: Outpatient Diag Procs/Tests/Lab Services: |
Home health care | Out-of-Network: Home Health Services: |
Mental health inpatient care | In-Network: Psychiatric Hospital Services: |
Mental health outpatient care | In-Network: Outpatient Mental Health Services: |
Outpatient services/surgery | Out-of-Network: Outpatient Hospital and ASC Services: |
Outpatient substance abuse care | In-Network: Outpatient Substance Abuse Services: |
Over-the-counter items | In-Network: Over-The-Counter (OTC) Items: |
Podiatry services | Out-of-Network: Podiatry Services: |
Skilled Nursing Facility (SNF) care | Out-of-Network: Coinsurance for Skilled Nursing Facility Services per Stay 30% |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Dental care | In-Network: Preventive Dental:
Comprehensive Dental:
Prior Authorization Required for Comprehensive Dental |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Vision benefits | Out-of-Network: Medicare Covered Vision Services: |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Hearing benefits | Out-of-Network: Medicare Covered Hearing Services: |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening
Yearly "Wellness" visit |
Prescription Drug Costs and Coverage
The UnitedHealthcare Medicare Advantage Assure (PPO) offers prescription drug coverage, with an annual drug deductible of $480.00 (excludes Tier 1)
Coverage | Cost |
---|---|
Coverage & Cost | |
Annual drug deductible | $480.00 (excludes Tier 1) |
Tier 1 | |
Annual drug deductible | $480.00 (excludes Tier 1) |
Tier 1 | |
Annual drug deductible | $480.00 (excludes Tier 1) |
Tier 1 |
When reviewing Illinois Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Illinois that offer similar benefits at similar or lower prices than the plan above. Call 1-855-580-1854 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
Links to plan documents |
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Illinois Counties Served
Boone Bureau Carroll Cook Dekalb Dupage Henderson Henry Jo Daviess Kane Kankakee Kendall Knox Lake Lee Marshall Mchenry Mclean Mercer Ogle Peoria Putnam Rock Island Sangamon Stark Stephenson Tazewell Warren Whiteside Will Winnebago Woodford
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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