H0271 046 - Jan 1, 2023 · Y0066_SB_H0271_023_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 ...

 
2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-000 . Accura mitteilung anleger aussetzung fondspreisberechnung.pdf

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 $1000.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined.Jan 1, 2023 · Y0066_SB_H0271_027_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 ... OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Choice (PPO D-SNP) Location: Denver, Colorado Click to see other locations. Plan ID: H0271 - 046 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageThe average monthly premium for Medicare Advantage plans in Denver is $13.91 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Denver County have an average Medicare Star Rating of 3.78 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare ... 2023 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.Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud queUnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2023 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. H0271 - 060 - 1 Click to see other plans: Member Services: 1-800-514-4912 TTY users 711 — Enrollment Options — Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance: Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit details Jan 1, 2023 · Y0066_SB_H0271_023_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 ... Y0066_EOC_H0271_046_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaY0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today.Y0066_SB_H0271_023_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 ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 NumberH0271 - 060 - 1 Click to see other plans: Member Services: 1-800-514-4912 TTY users 711 — Enrollment Options — Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance: Email a copy of the UnitedHealthcare Dual Complete Choice (PPO D-SNP) benefit detailsSpecialty doctor visit. $40 in-network / $50 out-of-network. Inpatient hospital care. $300 per day, days 1-7; $0 per day, days 8-90 in-network / 50% per stay out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $60.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $110.00.2023 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.2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Choice (PPO D-SNP) Location: Denver, Colorado Click to see other locations. Plan ID: H0271 - 046 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Specialty doctor visit. $40 in-network / $50 out-of-network. Inpatient hospital care. $300 per day, days 1-7; $0 per day, days 8-90 in-network / 50% per stay out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $60.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $110.00.Y0066_SB_H0271_006_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 ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageUnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 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 ...Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (PPO D-SNP) Location: Kanawha, West Virginia Click to see other locations. Plan ID: H0271 - 013 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Jan 1, 2023 · Y0066_SB_H0271_005_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 ... Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 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 ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Balance (PPO D-SNP) Location: Litchfield, Connecticut Click to see other locations. Plan ID: H0271 - 059 - 0 Click to see other plans. Member Services: 1-866-272-1967 TTY users 711. h0271-046-000 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.Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud queEnrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear H0271 - 027 - 0 Click to see other plans: Member Services: 1-800-643-4845 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Balance (PPO D-SNP) Location: Litchfield, Connecticut Click to see other locations. Plan ID: H0271 - 059 - 0 Click to see other plans. Member Services: 1-866-272-1967 TTY users 711. Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date.Jan 1, 2023 · Y0066_SB_H0271_046_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 ... 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (PPO D-SNP) Location: Kanawha, West Virginia Click to see other locations. Plan ID: H0271 - 013 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711. The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply. Y0066_SB_H0271_027_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 ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2023 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. Jan 1, 2023 · Enrollment Guide 2023 Take advantage of all your Medicare Advantage plan has to offer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 NumberGuía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Área de servicio: Colorado - condados de Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield,Y0066_SB_H0271_046_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 ... UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 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 Medicare Advantage Plan Benefit Details for the UnitedHealthcare Dual Complete Choice (PPO D-SNP) - H0271-046-0 Q1Medicare ®, Q1Rx ®, and Q1Group ® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group. H0271 - 036 - 0 Click to see other plans: Member Services: 1-800-643-4845 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance Sep 26, 2022 · Y0066_SB_H0271_046_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 ... Y0066_SB_H0271_046_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 ...2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-000 Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete Balance (PPO D-SNP) Location: Litchfield, Connecticut Click to see other locations. Plan ID: H0271 - 059 - 0 Click to see other plans. Member Services: 1-866-272-1967 TTY users 711. The UnitedHealthcare Dual Complete Choice (PPO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply. 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Location: Grant, New Mexico Click to see other locations. Plan ID: H0271 - 034 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711. Number of Members enrolled in this plan in (H0271 - 036): 2,359 members : Plan’s Summary Star Rating: 4 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 3 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...The UnitedHealthcare Chronic Complete Assure (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $505.00 (excludes Tiers 1, 2 and 3) Coverage. Cost. 30 day supply. 60 day supply. 90 day supply. Coverage & Cost. 30 day supply. 60 day supply.Jan 1, 2023 · Y0066_SB_H0271_016_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 ... Home Medicare Medicare Plans UnitedHealthcare Dual Complete Choice (PPO D-SNP) UnitedHealthcare Dual Complete Choice (PPO D-SNP) 4 out of 5 stars UnitedHealthcare Dual Complete Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-046. $ 0.00 Monthly Premium Colorado Counties Served 2022 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (PPO D-SNP) Location: Kanawha, West Virginia Click to see other locations. Plan ID: H0271 - 013 - 0 Click to see other plans. Member Services: 1-866-480-1086 TTY users 711.Medicare Advantage Plan Benefit Details in Plain Text. The following Medicare Advantage plan benefits apply to the UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271 - 046) in Denver, Colorado . This plan is administered by CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO..Y0066_EOC_H0271_046_000_2023_SP_C. OMB Approval 0938-1051 (Expires: February 29, 2024) Del 1 de enero al 31 de diciembre de 2023 Evidencia de CoberturaY0066_EOC_H0271_046_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 H0271-045-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0271-046-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H0624-001-000; 2023 UnitedHealthcare Dual Complete Plan Frequently Asked Questions H2582-002-000The average monthly premium for Medicare Advantage plans in Denver is $13.91 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Denver County have an average Medicare Star Rating of 3.78 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageY0066_SB_H0271_006_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 ...This page features plan details for 2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP) H0271 – 046 – 0 available in Select Counties in Colorado. IMPORTANT : This page has been updated with plan and premium data for 2023.Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare - H0271 For 2023, UnitedHealthcare - H0271 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 3.5 stars Drug Services Rating: 3 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 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.Y0066_SB_H0271_006_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 ...

Navigate to the CMS Enterprise Portal public home page. Login using your user ID and password. The CMS Enterprise Portal My Portal page is displayed, as shown in Figure 59: My Portal Page – My Profile Drop-down. Select the down arrow icon that appears next to your name at the top of page. Then select My Profile from the drop-down list to .... Cleveland moffett funeral home obits

h0271 046

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 $4500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined. Resumen de Beneficios 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud queY0066_SB_H0271_046_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 ... UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Jan 1, 2023 · Y0066_SB_H0271_023_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 ... UnitedHealthcare Chronic Complete Assure (PPO C-SNP) 4 out of 5 stars. UnitedHealthcare Chronic Complete Assure (PPO C-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H0271-027. $ 9.80. Monthly Premium. 2023 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.OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageThe average monthly premium for Medicare Advantage plans in Denver is $13.91 per month in 2023, though there may be plans available where you live that feature different premiums. Medicare Advantage plans in Denver County have an average Medicare Star Rating of 3.78 in 2023.*. Plans rated four stars or higher are considered top-rated Medicare ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Y0066_SB_H0271_006_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 ...28115. 9292. 37407. 1 1 5 38 3 19. 1 1 5 49 2 18. 1 1 5 351 75 19. 1 1 5 689 59 19. 1 49 219 49 2 1. 1 49 11 49 2 529. 1 128 230 128 101 1. 1 239 2 49 2 1. 1 287 13 38 3 8. 1 287 13 49 2 8. 1 287 13 351 75 7. 1 287 13 689 59 4. 1 287UnitedHealthcare offers UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plans for Maine and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. Specialty doctor visit. $40 in-network / $50 out-of-network. Inpatient hospital care. $300 per day, days 1-7; $0 per day, days 8-90 in-network / 50% per stay out-of-network. Urgent care. Urgent Care: Copayment for Urgent Care $60.00. Worldwide Coverage: Copayment for Worldwide Urgent Coverage $110.00..

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