4.5 out of 5 stars* for plan year 2023. $0.00 Monthly Premium. UnitedHealthcare Dual Complete (HMO-POS D-SNP) is a HMO-POS D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0169-002-000.Number of Members enrolled in this plan in (H0169 - 003): 7,149 members : Plan’s Summary Star Rating: 5 out of 5 Stars. This plan qualifies for the 5-star rating Special Enrollment period. Read more. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars.H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MNumber of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...Jan 1, 2023 · H0169-004-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_M VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. UnitedHealthcare Community Plan Feb 22, 2011 · Medicare Advantage & Other Health Plans in Iowa 2023 Iowa Insurance Division 1963 Bell Ave, Suite 100, Des Moines, IA 50315 1-800-351-4664 TTY 1-800-735-2942 The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 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 NumberThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 14,549 members. There are 131 members enrolled in this plan in Lawrence, Missouri, and 15,275 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as ... UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 plans for Missouri and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.Y0066_EOC_H0169_004_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 Evidence of Coverage for UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Table of Contents Questions? Call Customer Service at 1-866-842-4968, TTY 711, 8am-8pm: 7 Days Oct-o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ FemeninoY0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino H0169-002-000 MO HMO UnitedHealthcare Dual Complete Dual Neither H0169-003-000 NE HMO UnitedHealthcare Dual Complete Dual Neither H0169-004-000 KS HMOPOS UnitedHealthcare Dual Complete LP1 Dual Neither H0251-002-000 TN HMO UnitedHealthcare Dual Complete Dual Neither Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger,Number of Members enrolled in this plan in (H0169 - 004): 1,480 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...H0169-004-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_MJan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, Number of Members enrolled in this plan in (H0169 - 004): 1,480 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MWe would like to show you a description here but the site won’t allow us.UnitedHealthcare - H0169 For 2023, UnitedHealthcare - H0169 received the following Star Ratings from Medicare: Overall Star Rating: 4.5 stars Health Services Rating: 4 stars Drug Services Rating: 4 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 Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000Sep 26, 2022 · H0169-008-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_008_000_2023_M Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...H0169-002-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com Medicare options – Missouri only unless stated otherwise. Medicare – Medicare Part B (called traditional Medicare) is managed by the government agency called Centers for Medicare and Medicaid Services or CMS. This plan issues a red, white and blue enrollment card. For information or to enroll call 800-633-4227. H0169-002-000 MO HMO UnitedHealthcare Dual Complete Dual Neither H0169-003-000 NE HMO UnitedHealthcare Dual Complete Dual Neither H0169-004-000 KS HMOPOS UnitedHealthcare Dual Complete LP1 Dual Neither H0251-002-000 TN HMO UnitedHealthcare Dual Complete Dual NeitherH0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MH0169-002-000 MO99MODSNPF MO99MODSNPP MO99MODSNPQ ... H0169-008-000 MO99MODSNP3F MO99MODSNP3P MO99MODSNP3Q UnitedHealthcare Dual Complete® Choice (PPO D-SNP)As an Arkansas Blue Medicare member, you’ll be eligible to earn valuable rewards for getting exams, preventive screenings, tests and completing other health-related activities. Comprehensive dental benefits. $0 copay for 1 routine hearing exam per year. $699/$999 copay per hearing aid (2 per year) Please see plan documents for more details.Maximum 3 visits every year. 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 $4000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.Medicare options – Missouri only unless stated otherwise. Medicare – Medicare Part B (called traditional Medicare) is managed by the government agency called Centers for Medicare and Medicaid Services or CMS. This plan issues a red, white and blue enrollment card. For information or to enroll call 800-633-4227.2022 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans. Aug, 18 2023 — Based on the 2024 Medicare Part D plan bids and June plan enrollment, the 2024 average total Part D premium is projected to be $55.50 per month, a decrease of 1.8 percent from the 2023 average total premium of $56.49.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Plan Benefits Details2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 Medicare Advantage Quick Reference Guide - Missouri-Illinois POS and PPO PlansGuía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, 2023 Missouri UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: H0169-002-000 Subject: UnitedHealthcare Community Plan of Missouri manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Created Date: 20230218034507ZY0066_ANOC_H0169_002_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ...Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Área de servicio: Missouri - condados de Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates,A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244UnitedHealthcare - H0169 For 2023, UnitedHealthcare - H0169 received the following Star Ratings from Medicare: Overall Star Rating: 4.5 stars Health Services Rating: 4 stars Drug Services Rating: 4 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 ... The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 002) currently has 18,440 members. There are 286 members enrolled in this plan in St. Francois, Missouri, and 18,325 members in Missouri. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-008-000 plan for Missouri. Check eligibility, explore benefits, and enroll today.UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Sanctioned Plan The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169-002-0) Formulary Drugs Starting with the Letter A in Howard County, MO: CMS MA Region 15 which includes: MO: Drugs Starting with Letter A Drug Name Drug Tier Information Cost-Sharing Drug Usage Mgmt; Tier Nbr. TierThe UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 001) currently has 14,992 members. There are 15 members enrolled in this plan in Hancock, Iowa, and 14,934 members in Iowa. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.The UnitedHealthcare Dual Complete (HMO D-SNP) (H0169 - 001) currently has 14,992 members. There are 15 members enrolled in this plan in Hancock, Iowa, and 14,934 members in Iowa. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars. UnitedHealthcare Community PlanJan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. Y0066_EOC_H0169_001_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ FemeninoJan 1, 2023 · H0169-001-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_001_000_2023_M Y0066_EOC_H0169_002_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® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-006-000 plan for Nebraska. Check eligibility, explore benefits, and enroll today.2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-008-000; 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0271-029-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0169-002-000 Sep 26, 2022 · H0169-008-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_008_000_2023_M 2023 Missouri UnitedHealthcare Dual Complete® Plan Frequently Asked Questions: H0169-002-000 Subject: UnitedHealthcare Community Plan of Missouri manages the Medicare Advantage benefits and reimburses you according to your existing contracted rates. Created Date: 20230218034507Z This page features plan details for 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0169 – 002 – 0 available in Select Counties in Missouri. IMPORTANT : This page has been updated with plan and premium data for 2023.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H0169-002-0 in MO Star Rating Details Number of Members enrolled in this plan in (H0169 - 004): 1,480 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 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_ANOC_H0169_002_000_2023_M. Y0066_210610_INDOI_C Find updates to your plan for next year This notice provides information about updates to your plan, but it ...Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 Service area: Missouri - Adair, Andrew, Atchison, Audrain, Barry, Barton, Bates, Benton, Bollinger, Learn more about the UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) H0169-006-000 plan for Nebraska. Check eligibility, explore benefits, and enroll today.Jan 1, 2023 · H0169-004-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_004_000_2023_M UnitedHealthcare Dual Complete® (HMO-POS D-SNP) UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP) Complete Drug List (Formulary) 2023 Important notes: This document has information about the drugs covered by this plan. Y0066_EOC_H0169_004_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Number of Members enrolled in this plan in (H0169 - 002): 24,875 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 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 Community PlanH0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCCommunityPlan.com Y0066_SB_H0169_002_000_2022_M. www.UHCCommunityPlan.comY0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage
2018 UnitedHealthcare Dual Complete (HMO SNP) - H0169-002-0 in MO Plan Benefits Details . H and r block near me open
Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Pulaski, Missouri Click to see other locations. Plan ID: H0169 - 002 - 0 Click to see other plans. Member Services: 1-844-368-6886 TTY users 711.Number of Members enrolled in this plan in (H0169 - 002): 14,549 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.Number of Members enrolled in this plan in (H0169 - 002): 38,511 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ...Jan 1, 2023 · H0169-001-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_001_000_2023_M 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H0169-002-000 Subject UnitedHealthcare Dual Complete additional benefit overview for health care professionals. H0169-002-000 MO99MODSNPF MO99MODSNPP MO99MODSNPQ ... H0169-008-000 MO99MODSNP3F MO99MODSNP3P MO99MODSNP3Q UnitedHealthcare Dual Complete® Choice (PPO D-SNP)2018 Medicare Part D Contract ID/Plan ID Search. Q1Medicare.com providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 Datos del miembro (escriba a máquina o en letra de molde con tinta negra o azul) Apellidos Nombre Inicial del segundo nombre Fecha de nacimiento Sexo ¨ Masculino ¨ Femenino UnitedHealthcare Community Plan H0169-002-000 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. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_000_2023_MJan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H0169_002_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 complete list of covered services, limitations and exclusions. Y0066_EOC_H0169_002_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H0169-002-000 - UD5 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 Evidence of Coverage for UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Table of Contents Questions? Call Customer Service at 1-866-842-4968, TTY 711, 8am-8pm: 7 Days Oct- .