Disclaimer

Erickson Medicare Advantage® Pre-Enrollment Disclaimer

This information is not a complete description of benefits. Benefits, features, and/or prices may vary by plan/area. Limitations, exclusions, and/or network restrictions may apply.

• Call 1-866-314-8188, TTY 711 for more information.
• Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare.
• OTC benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.
• The Giveback benefit is a reduction on your Medicare Part B premium.
• Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider. 
• If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. Network size varies by local market. 
• Annual routine eye exam and $100-500 allowance for contacts or 1 pair of frames, with standard (single, bi-focal, tri-focal, or standard progressive) lenses covered in full either every year or every two years. 
• $0 copay may be restricted to particular tiers, preferred medications, or home delivery prescriptions and may not apply across all coverage phases.
• *Every year, Medicare evaluates plans based on a 5-star rating system. This five-out-of-five-star rating applies to contract number H5652 for the years 2021–2025.

Declaration of Disaster or Emergency

If you're affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

• Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
• Where applicable, requirements for gatekeeper referrals are waived in full;
• Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
• The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.
• If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.

Call 1-866-314-8188, TTY: 711, for more information.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare.