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UHC Complete Care GA-3 (PPO C-SNP)
The Centers for Medicare & Medicaid Services (CMS) publishes annual Star Ratings that reflect how each Medicare Advantage plan performs across a range of metrics, using a system of one to five stars.
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Monthly Premium
UHC Complete Care GA-3 (PPO C-SNP) is a PPO C-SNP plan offered by UnitedHealthcare
Plan ID: H1889-020
HelpAdvisor Editorial Team analysis of data from the 2027 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as UHC Complete Care GA-3 (PPO C-SNP) - H1889-020 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.
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Monthly Premium
Georgia Counties Served
ApplingAtkinsonBaconBakerBaldwinBanksBarrowBartowBen HillBerrienBibbBleckleyBrantleyBrooksBryanBullochBurkeButtsCalhounCamdenCandlerCarrollCatoosaCharltonChathamChattahoocheeChattoogaClarkeClayClinchCoffeeColquittColumbiaCookCowetaCrawfordCrispDadeDawsonDecaturDodgeDoolyEarlyEcholsEffinghamElbertEmanuelEvansFanninFloydFranklinGadsdenGilmerGlascockGlynnGordonGradyGreeneHabershamHallHancockHaralsonHarrisHartHeardHoustonIrwinJacksonJasperJeff DavisJeffersonJenkinsJohnsonJonesLamarLanierLaurensLeeLibertyLincolnLongLowndesLumpkinMaconMadisonMarionMcduffieMcintoshMeriwetherMillerMitchellMonroeMontgomeryMorganMurrayMuscogeeNewtonOconeeOglethorpePauldingPeachPickensPiercePikePolkPulaskiPutnamQuitmanRabunRandolphRichmondSchleyScrevenSeminoleSpaldingStephensStewartSumterTalbotTaliaferroTattnallTaylorTelfairTerrellThomasTiftToombsTownsTreutlenTroupTurnerTwiggsUnionUpsonWalkerWaltonWareWarrenWashingtonWayneWebsterWheelerWhiteWhitfieldWilcoxWilkesWilkinsonWorth
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Drug Deductible | $685 |
| Out of Pocket Max | In-Network: $9850 Out-of-Network: N/A |
| Initial Coverage Limit | $0 |
| Catastrophic Coverage Limit | $2100 |
| Primary Care Doctor Visit | Out-of-Network: Doctor Office Visit Services: Copayment for Medicare Covered Primary Care Office Visit $20 |
| Specialty Doctor Visit | Out-of-Network: Doctor Specialty Visit Services: Copayment for Medicare Covered Physician Specialist Office Visit $85 Note: The lower cost share applies to Medicare covered telehealth and Medicare covered remote monitoring. The higher cost share applies to all other Medicare covered services. |
| Inpatient Hospital Care | Out-of-Network: Acute Hospital Services: $715 per day for days 1 to 14 $0 per day for days 15 to 999 Note: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. |
| Urgent Care | Urgent Care: Copayment for Urgent Care $0 to $40 Note: The lower cost share applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services. |
| Emergency Room Visit | Emergency Care: Copayment for Emergency Care $115 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours |
| Ambulance Transportation | Out-of-Network: Ambulance Services: Copayment for Medicare Covered Ambulance Services - Ground $400 Copayment for Medicare Covered Ambulance Services - Air $400 |
Health Care Services and Medical Supplies
UHC Complete Care GA-3 (PPO C-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
| Coverage | Cost |
|---|---|
| Chiropractic Services | Out-of-Network: Chiropractic Services: Copayment for Medicare Covered Chiropractic Services $85 In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 Prior Authorization Required for Chiropractic Services |
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | Out-of-Network: Diabetic Supplies and Services: Coinsurance for Medicare Covered Diabetic Supplies 50% Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 50% |
| Durable Medical Equipment (DME) | In-Network: Durable Medical Equipment: Coinsurance for Medicare-covered Durable Medical Equipment 20% Prior Authorization Required for Durable Medical Equipment |
| Diagnostic Tests, Lab and Radiology Services, and X-Rays | Out-of-Network: Diagnostic Procedures/Tests Services: Copayment for Medicare Covered Diagnostic Procedures/Tests $75 Copayment for Medicare Covered Lab Services $0 Copayment for Medicare Covered Diagnostic Radiological Services $385 Coinsurance for Medicare Covered Therapeutic Radiological Services 40% Copayment for Medicare Covered Outpatient X-Ray Services $50 |
| Home Health Care | Out-of-Network: Home Health Services: Coinsurance for Medicare Covered Home Health 50% |
| Mental Health Inpatient Care | In-Network: Psychiatric Hospital Services: $610 per day for days 1 to 3 $0 per day for days 4 to 90 Prior Authorization Required for Psychiatric Hospital Services Benefit Details - General Note - NOTE ON INPATIENT SUBSTANCE ABUSE: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b. |
| Mental Health Outpatient Care | Out-of-Network: Mental Health Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 |
| Outpatient Services / Surgery | Out-of-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $715 Copayment for Medicare Covered Ambulatory Surgical Center Services $715 Note: The lower cost share applies to outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Note: Benefit category includes both the facility and professional component. |
| Outpatient Substance Abuse Care | In-Network: Outpatient Substance Abuse Services: Copayment for Medicare-covered Individual Sessions $0 to $25 Copayment for Medicare-covered Group Sessions $15 Prior Authorization Required for Outpatient Substance Abuse Services Note: The lower cost share applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 Note: The lower cost share applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. |
| Over-the-counter (OTC) Items | In-Network Over-The-Counter (OTC) Items: $40 credit per month for OTC products like first aid supplies, pain relievers and more, plus healthy food like fruits, vegetables and meat for qualifying members. Shop at thousands of participating stores, including Walmart, Walgreens and Dollar General, or at neighborhood stores near you. |
| Podiatry Services | In-Network $0 copay 6 visits per year Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $85 |
| Skilled Nursing Facility Care | In-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $221 per day for days 21 to 100 Prior Authorization Required for Skilled Nursing Facility Services |
Dental Benefits
The following dental services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Dental Care | Out-of-Network: Preventive Dental Services: Coinsurance for Medicare Covered Preventive Dental 40% |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | Out-of-Network: Eye Exams Services: Copayment for Medicare Covered Eye Exams $85 Copayment for Medicare Covered Eyewear $85 |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | Out-of-Network: Hearing Exams Services: Copayment for Medicare Covered Hearing Exams $85 |
Preventive Services and Health/Wellness Education Programs
The following services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Preventive Services and Health/Wellness Education Programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit |
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