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. 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 NumberCopayment 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.H0271 027 * 4. Christian. UnitedHealthcare; UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Local PPO Chronic or Disabling Condition $ 9.80 $ 505.00 No; DS H0271;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 ...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 ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 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_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 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 Coverage2023 UnitedHealthcare (H0271) Star Rating Details. UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-046-0) Benefits & Contact Info. The UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-046-0) in Fremont, CO: CMS MA Region 20 which includes: CO. Star Rating Category & Measures. 2023. 2022. 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 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 queJan 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 ... 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 (H0271) Star Rating Details. UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-046-0) Benefits & Contact Info. The UnitedHealthcare Dual Complete Choice (PPO D-SNP) (H0271-046-0) in Fremont, CO: CMS MA Region 20 which includes: CO. Star Rating Category & Measures. 2023. 2022. 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 ...Medicare Advantage plan with prescription drugs Summary of benefits 2022 UnitedHealthcare Dual Complete® (HMO D-SNP) H0624-001-000 Look inside to take advantage of the health services and drug coverages the plan provides. Y0066_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, 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 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.o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 ¨ Femenino H0271 027 * 4. Christian. UnitedHealthcare; UnitedHealthcare Chronic Complete Assure (PPO C-SNP) Local PPO Chronic or Disabling Condition $ 9.80 $ 505.00 No; DS H0271; TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ...Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of CoverageCopayment 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. 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_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 ...Health Plans Colorado 2023 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 UnitedHealthcare Dual Complete® Choice (PPO D-SNP) CMS Rating Medicare What is a dual special needs plan? H0271-046 -000 Monthly premium: $ 0.00 * * Your costs may be as low as $0, depending on your level of Medicaid eligibility. Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage UnitedHealthcare offers UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-046-000 plans for Colorado and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.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. 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.The 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 ... TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ... 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_SB_H0271_007_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. 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.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.Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today.Learn more about the UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 plan for Colorado. Check eligibility, explore benefits, and enroll today.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 detailsResumen 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 queJan 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 ... 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.o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 ¨ Femenino2023 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 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 711.2023 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.o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 ¨ Femenino 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. 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.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Chronic Complete (PPO C-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $0.2023 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. Evidence of Coverage 2023 UnitedHealthcare® Chronic Complete Assure (PPO C-SNP) Toll-free 1-877-370-3249, TTY 711 24 hours a day, 7 days a week myUHCMedicare.com Y0066_EOC_H0271_036_000_2023_CJan 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 ... Y0066_EOC_H0271_046_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage2022 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.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 ...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. The 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 ... 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. 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 NumberSep 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 ... 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.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. 8 a.m.-8 p.m. local time, 7 days a week UHC.com/Medicare 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 Coverage (EOC) for a complete list of covered services, limitations and exclusions.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. 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.H0271-046-000 Service area: Colorado - Adams, Alamosa, Arapahoe, Bent, Boulder, Broomfield, Chaffee, Clear Creek, Conejos, Costilla, Crowley, Custer, Denver, Douglas, El Paso, Elbert, Fremont, Gilpin, Grand, Huerfano, Jefferson, Lake, Larimer, Las Animas, Lincoln, Logan, Morgan, Otero, Park, Pueblo, Teller, Washington, Weld countiesLearn 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.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 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.Plan ID: H0271-036-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $13.30 Monthly Premium. Oregon Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A ...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. 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..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.
UnitedHealthcare offers UnitedHealthcare Dual Complete® (PPO D-SNP) H0271-046-000 plans for Colorado and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. . Juicer for sale
TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Medicare Advantage Assure (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $29.10 (see Plan Premium Details below) Annual Deductible: $480. Annual Initial Coverage Limit (ICL):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 ...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ... 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. 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 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.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_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 Coverage o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 ¨ Femenino 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, Y0066_SB_H0271_036_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 ...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 ... o UnitedHealthcare Dual Complete® Choice (PPO D-SNP) H0271-046-000 - UO7 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 ¨ Femenino 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_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.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 Cobertura 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_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 Coberturao 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 Number.
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