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Coverage And Benefits
Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.
Important Information about your Part D Vaccine and Insulin Coverage
What You Pay for Vaccines – Our plan covers most adult Part D vaccines at no cost to you.
What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.
MoDOT-MSHP Group Medicare Advantage (PPO)
2024 materials:
Preventive services
The following preventive services are covered under your plan for a $0 copay when you visit your primary care physician:
- Screening and counseling to reduce alcohol misuse
- Screening for depression in adults
- Screening for Sexually Transmitted Infections (STIs) and high intensity behavioral counseling to prevent STIs
- Intensive behavioral therapy to reduce cardiovascular disease risk
- Screening and counseling for obesity
For more information about these preventive services, please call the Customer Service number on your plan ID card.
Benefits and costs
| Benefit | UnitedHealthcare® Group Medicare Advantage (PPO) |
|---|---|
| Annual medical deductible | $250 |
| Annual out-of-pocket maximum | $250 |
| Office and clinic visits | $0 copay |
| Hospital services (inpatient) | $0 copay |
| Hospital services (outpatient) | $0 copay |
| Prescription drug coverage | Retail Tier 1: $15 copay Mail Order Tier 1: $37.50 copay |
Disclaimer
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the costsharing that applies to out-of-network services.