Introduction facility that is currently Medicare-approved for your specific type of transplant. The plan’s hospital network for organ transplant services is different than the network shown in the “Hospitals” section 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 $3500.00 every year for Preventive and Non-Medicare Covered Comprehensive combined.The UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) (H5322 - 031) currently has 28,022 members. There are 44 members enrolled in this plan in Greer, Oklahoma, and 27,957 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 5 stars.Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Catastrophic drug coverage limit. $7,400.00. Primary care doctor visit. $0 in-network / $55 out-of-network. Specialty doctor visit. $35 in-network / $60 out-of-network. Inpatient hospital care. $375 per day, days 1-5; $0 per day, days 6-90 in-network / 50% per stay out-of-network. Urgent care.Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageThe UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 528 members enrolled in this plan in Canadian, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars.5 out of 5 stars UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00 Monthly Premium Oklahoma Counties Served 2022 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. . UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) CMS Rating Medicare What is a dual special needs plan? H5322-031 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. 2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ... 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ...Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS)Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS)UnitedHealthcare offers UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plans for Oklahoma and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. UnitedHealthcare Dual Complete® LP (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. 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete LP (HMO D-SNP) Location: Tillman, Oklahoma Click to see other locations. Plan ID: H5322 - 031 - 0 Click to see other plans. Member Services: 1-844-368-7150 TTY users 711.UnitedHealthcare Dual Complete® LP (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_H5322_031_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de Cobertura2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details Catastrophic drug coverage limit. $7,400.00. Primary care doctor visit. $0 in-network / $55 out-of-network. Specialty doctor visit. $35 in-network / $60 out-of-network. Inpatient hospital care. $375 per day, days 1-5; $0 per day, days 6-90 in-network / 50% per stay out-of-network. Urgent care. Number of Members enrolled in this plan in (H5322 - 030): 3,347 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • 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 ...H5322-031 OK99OKDSNPF OK99OKDSNPP OK99OKDSNPQ UnitedHealthcare Dual ... H5322-033 OK99OKDSNP4F, OK99OKDSNP4P, OK99OKDSNP4Q. 2022 United HealthCare Services Inc. All ... H5322-031 OK99OKDSNPF OK99OKDSNPP OK99OKDSNPQ UnitedHealthcare Dual ... H5322-033 OK99OKDSNP4F, OK99OKDSNP4P, OK99OKDSNP4Q. 2022 United HealthCare Services Inc. All ...2022 UnitedHealthcare Dual Complete LP (HMO D-SNP) - H5322-031-0 in OK Star Rating Details H3749-001-000, H3749-017-000, H3749-018-000, H3749-020-000, H8768-008-000, H8768-009-000, H8768-016-000, H8768-028-000, H5322-031-000. NEW 2023: H0271-053-000, H5322-033-000. Texas: Corpus Christi: For WellMed impacted plans, billing instructions, provider eligibility and other details, please reference https://www.wellmedhealthcare.com ... H5322-031-000 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.comY0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageProvider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Canadian, Cleveland, Kingfisher, Lincoln, Logan and Oklahoma Counties UnitedHealthcare - H5322 For 2023, UnitedHealthcare - H5322 received the following Star Ratings from Medicare: Overall Star Rating: 5 stars Health Services Rating: 5 stars Drug Services Rating: 4.5 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 ... Introduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areao UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 2019 UnitedHealthcare Dual Complete (HMO SNP) - H5322-031-0 in OK Plan Benefits Explained Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS)Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com.o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 ¨ FemeninoH5322-031-000 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.comY0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage We would like to show you a description here but the site won’t allow us.UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) 5 out of 5 stars. UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00.Resources and tools for providers and health care ...Number of Members enrolled in this plan in (H5322 - 025): 48,964 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.Catastrophic drug coverage limit. $7,400.00. Primary care doctor visit. $0 in-network / $55 out-of-network. Specialty doctor visit. $35 in-network / $60 out-of-network. Inpatient hospital care. $375 per day, days 1-5; $0 per day, days 6-90 in-network / 50% per stay out-of-network. Urgent care. Plan Name Effective Year Benefit Package Summary; H5322-031 - UnitedHealthcare Dual Complete LP (HMO D-SNP) 2023: H5322-031: Download: AARP Medicare Advantage Plan 1 (HMO-POS) UnitedHealthcare Dual Complete® LP (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 Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 Social Security Number (Required for people who are enrolling in D-SNP plans): _ _ Medicare Number Permanent Residence Street Address (P.O. Box is not allowed) City County State ZIP Code Mailing Address (Only if it’s different from above. You can give a P.O. Box.) CityEnrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Service area: Oklahoma - Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan, Caddo, Canadian,H5322-031-000 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_H5322_031_000_2023_MQuick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com.H5322-031-000 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_H5322_031_000_2023_M2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL):H5322-031-000 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_H5322_031_000_2022_MGuía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Área de servicio: Oklahoma - condados de Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan,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 ...2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-031-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H5322-033-000; 2023 UnitedHealthcare Dual Complete Plan Quick Reference Guide for Oklahoma; 2022 Plan Resource Materials. 2022 UnitedHealthcare Dual Complete® Plan Frequently Asked Questions ...PCA-1-21-02928-M&R-QRG_08252021 Sample member ID cards for illustration only; actual information varies depending on payer, plan and other requirements.Quick reference guide 2022 UnitedHealthcare Care Provider Administrative Guide iii Contact UnitedHealthcare Most questions can be answered using our online solutions at uhcprovider.com. Y0066_EOC_H5322_031_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 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 ...5 out of 5 stars UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H5322-031. $ 0.00 Monthly Premium Oklahoma Counties Served Vendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contacting The UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 13,894 members. There are 309 members enrolled in this plan in Creek, Oklahoma, and 13,829 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings are as ... Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Área de servicio: Oklahoma - condados de Adair, Alfalfa, Atoka, Beaver, Beckham, Blaine, Bryan,2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete LP (HMO D-SNP) Location: Tillman, Oklahoma Click to see other locations. Plan ID: H5322 - 031 - 0 Click to see other plans. Member Services: 1-844-368-7150 TTY users 711.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. UnitedHealthcare Dual Complete® LP (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. Introduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service areaThe UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 114 members enrolled in this plan in Craig, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. Llame al número gratuito 1-800-313-0973 (TTY 711). Se encuentran disponibles agentes con licencia del 1 de octubre al 31 de marzo, de 8 a. m. a 8 p. m. , hora local, Y0066_ANOC_H5322_031_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 ...UnitedHealthcare offers UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 plans for Oklahoma and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Vendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contacting Number of Members enrolled in this plan in (H5322 - 030): 3,347 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • 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 ...H5322-030-000 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_H5322_030_000_2023_M729 Medicare Advantage Plans from Humana. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0028:007-0 Humana Gold Plus SNP-DE H0028-007 (HMO D-SNP) H0028:014-0 Humana Gold Plus H0028-014 (HMO) H0028:015-0 Humana Gold Plus SNP-DE H0028-015 (HMO-POS D-SNP) H0028 ... The table below outlines some of the specific plan details for UnitedHealthcare Medicare Advantage plans available in Oklahoma in 2023. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket Max. Prescription Drug Coverage. Medicare.Jan 1, 2023 · H5322-033-000 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_H5322_033_000_2023_M The UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 528 members enrolled in this plan in Canadian, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars.Resources and tools for providers and health care ...H5322-031 OK99OKDSNPF OK99OKDSNPP OK99OKDSNPQ UnitedHealthcare Dual ... H5322-033 OK99OKDSNP4F, OK99OKDSNP4P, OK99OKDSNP4Q. 2022 United HealthCare Services Inc. All ... 2019 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO SNP) Location: Oklahoma, Oklahoma Click to see other locations. Plan ID: H5322 - 031 - 0 Click to see other plans. Member Services: 1-844-368-7150 TTY users 711.Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-030-000 plan for Georgia. Check eligibility, explore benefits, and enroll today.
Introduction If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service area. Ajvr 184
2022 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.Provider Directory 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Oklahoma Alfalfa, Atoka, Beaver, Beckham, Blaine, Caddo, Choctaw, Cimarron, Coal, Comanche ...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. UnitedHealthcare Dual Complete® LP (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. H3749-001-000, H3749-017-000, H3749-018-000, H3749-020-000, H8768-008-000, H8768-009-000, H8768-016-000, H8768-028-000, H5322-031-000. NEW 2023: H0271-053-000, H5322-033-000. Texas: Corpus Christi: For WellMed impacted plans, billing instructions, provider eligibility and other details, please reference https://www.wellmedhealthcare.com ... UnitedHealthcare Dual Complete® LP (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.H5322-031-000 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_H5322_031_000_2023_MY0066_ANOC_H5322_031_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 ... Vendor Information UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) Take advantage of your additional plan benefits by using the providers below or contacting H5322-031-000 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 Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $0.00. Prior Authorization Required for Doctor Specialty Visit. Inpatient hospital care. In-Network: Acute Hospital Services: $0.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Acute Hospital Services. o UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 - UL4 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 The UnitedHealthcare Dual Complete LP (HMO D-SNP) (H5322 - 031) currently has 23,586 members. There are 528 members enrolled in this plan in Canadian, Oklahoma, and 23,493 members in Oklahoma. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars.h5322 care improvement plus south central insurance co. h5325 coventry health care of kansas, inc. h5410 healthspring of florida, inc. h5420 h5422 blue cross blue shield healthcare plan of georgia h5425 scan health plan h5427 078 freedom health, inc. h5431 healthsun health plans, inc. h5433 orange county health authority h5447 community first ...CST33015_H5322-031-000 Key contacts for additional benefits Member ID Medicaid Medicare Health Plan (80840): 999-99999-99 Member ID: Member: PCP Name: DR. PROVIDER BROWN PCP Phone: (999)999-9999 Payer ID: 999999999 Group Number: SUBSCRIBER BROWN Rx Bin: 999999 Rx Grp: XXXXXXXX Rx PCN: 9999 Sample ID cards Dental Phone: 1-844-275-8750 Monday ...Resources and tools for providers and health care ....