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Ultimate Health Plans

Details: Ultimate Health Plans is a Medicare Advantage Plan based in Spring Hill, Florida. We proudly serve people with Medicare exclusively. At Ultimate Health Plans, we take pride in our Member-centered approach to customer service and the coordination of excellent benefits to meet all your health …

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Ultimate Health Plans Member Homepage

Details: Recently, Ultimate Health Plans’ Pharmacy Benefit Manager (PBM), CastiaRx, was acquired by OptumRx. As part of this change, beginning June 1, 2020, OptumRx will manage your pharmacy benefits. Our Pharmacy Help Desk phone number and your pharmacy benefits will …

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Ultimate Health Plans Provider Homepage

Details: Ultimate Health Plans is committed to protecting the health and safety of our members. As such, we follow all CMS guidelines for providing benefits during the COVID-19 pandemic. Please refer to the CMS COVID-19 Partner Toolkit for additional information:

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Find a Doctor, Hospital, Medical Facility or Pharmacy

Details: Ultimate Health Plans’ network providers in Citrus, Hernando, Hillsborough, Pasco and Pinellas county in 2021. Central Florida Provider & Pharmacy Directory / Directorio de proveedores y farmacias Florida Central Y Treasure Coast This directory provides a list of Ultimate Health Plans’ network providers

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Contact Ultimate Health Plans

Details: Contact Ultimate Health Plans. Pick one of the choices below for more information. We have implemented our public health protocols in response to the Coronavirus (COVID-19). To protect the health of our members, our offices have temporarily restricted in-office visits. For assistance, please contact Member Services at 1-888-657-4170 (TTY: 711).

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Search for a Provider, Specialist or Facility

Details: Ultimate Health Plans’ network providers in Citrus, Hernando, Hillsborough, Pasco and Pinellas county in 2021. Central Florida Provider & Pharmacy Directory / Directorio de proveedores y farmacias Florida Central Y Treasure Coast This directory provides a list of Ultimate Health Plans’ network providers

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Prior Authorizations and Referrals

Details: Ultimate Health Plans processes authorization requests according to the following general time frames, which comply with Medicare guidelines: Standard- decision within 14 calendar days from the date of request.; Expedited- decision within 72 hours from the date of the request (including weekends and holidays).Conditions meeting criteria for expedited review include an imminent or serious

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UHP Over-the-Counter (OTC) Medications and Products

Details: quarterly benefit allowance to purchase medications, health- and wellness-related items, first-aid supplies and other qualifying items, and have them shipped directly to your home. If you have any questions or need help placing your order, we’re here for you. Member Experience Advisors are available at . 1-855-422-0039 (TTY: 711).

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Over-the-Counter (OTC) Benefit

Details: 3001 Health-Related Smart Phone (please refer to page 7 for details) 1 $35 per month MOTION SICKNESS MEDICATION 115 Motion Sickness Tablets 12 $3 OTHER PRODUCTS AND AIDS FOR DAILY LIVING 472 Adult Washcloths Disposable 48 $5 118 Antibacterial Wet Wipes 24 $4 216 Bathroom Scale, Dial, to 300 lbs‡ 1 $12 226 Bug X Repellent 2 oz. $8

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Welcome to Ultimate Health Plans

Details: Welcome to Ultimate Health Plans. ***COVID-19*** There is an Emergency Declaration in place for the State of Florida and Nationally. We are here for you. Please click here to learn how Ultimate Health Plans provides benefits during an Emergency. Ultimate Health Plans offers coverage for doctors visits, hospital care, prescription drugs, and

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Provider Benefit Summaries

Details: Provider Benefit Summaries. Indian River/St. Lucie County 033 - Advantage Care by Ultimate (HMO) Indian River/St. Lucie County 034 - Advantage Care COPD by Ultimate (HMO) Lake/Marion/Sumter County - 029 Advantage Care by Ultimate (HMO-CSNP) Lake/Marion/Sumter County - 030 Advantage Care COPD by Ultimate (HMO-CSNP) Pasco/Hernando County - 024

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Prescription Drug Coverage Information and Formulary

Details: Ultimate Health Plans Prescription Drug Transition Policy: Ultimate Health Plans will cover a Transition Supply for enrollees who have a level of care change which is defined as when enrollees: Enter a Long-Term-Care (LTC) facility from a hospital or other setting. Leave a Long-Term-Care (LTC) facility and return to the community.

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Public Health Emergency Declaration, COVID-19

Details: Ultimate Health Plans follows all CMS guidelines for providing benefits during disaster or public health emergency declarations. In the event of a Presidential emergency declaration, a Presidential (major) disaster declaration, a declaration of emergency or disaster by the Governor, or an announcement of a public health emergency by the

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Member Forms & Resources

Details: of Health Office of Communications 1-850-245-4111 (TTY dial 711) to receive a copy. Clinical Practice Guidelines. These Preventive Care Guidelines address routine health exams, diagnostic checkups, counseling and immunizations recommended for adults. Discuss these general guidelines with your doctor to stay as healthy as possible throughout the

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Appeals and Grievances

Details: WRITE Ultimate Health Plans, Inc., P.O. Box 3146, Scranton, PA 18505 Appeals for Medical Care An appeal is a formal way of asking us to review …

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Enroll Now in Ultimate Health Plans

Details: Call 1-855-858-7526 to speak with an Ultimate Health Plans representative. Also you can enroll by filling out the form below and mailing it to us at Ultimate Health Plans P.O. Box 6560 Spring Hill, FL 34611. Enrollment Form - English for 2021 Plans Formulario de solicitud de inscripción - Spanish

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Formulary and Prescription Drug Information

Details: For example, the plan might: Add or remove drugs from the Drug List. Move a drug to a higher or lower cost-sharing tier. Add or remove a restriction on coverage for a drug. Replace a brand name drug with a generic drug. Changes to our Formulary (both additions and deletions) are also listed on this website in the following document.

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Ultimate Health Plans Compliance and FWA Training for

Details: Compliance and FWA Training. As a First Tier Entity, your organization must provide FWA and general compliance training to all your employees and Downstream Entities assigned to provide administrative and/or healthcare services for Ultimate Health Plans. To comply with this requirement, you can use the CMS Medicare Parts C & D Fraud, Waste, and

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Out of Network Coverage

Details: If an out-of-network provider is used, authorization should be obtained from Ultimate Health Plans prior to seeking care. In this situation, you will pay the same as you would pay if you got the care from a network provider. For information about getting approval to see an out-of-network doctor, see Section 2.4 in Chapter 3 of the EOC.

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2021 Summary of Benefits

Details: Good health is where you live. Live the Ultimate Life. HOW TO USE THIS BOOKLET Thank you for taking the time to learn about. Ultimate Health Plans. We hope you find this time well spent. Ultimate, as our members call us, is a local plan with operations and customer service based right here in Central Florida. Our main office is located in

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2021 Summary of Benefits

Details: Ultimate Health Plans. We hope you find this time well spent. Ultimate, as our members call us, is a local plan with operations and customer service based right here in Central Florida. Our main office is located in Spring Hill. We have a large (and growing) network of local doctors and hospitals conveniently located throughout Indian River and

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2021 UHP Provider Manual

Details: Ultimate Health Plans’ “Provider Manual” was developed for use by contracted Providers and their staff. It is included by reference in the contractual agreement (the “Agreement”) between Ultimate Health Plans and the Provider, and it is intended to establish guidelines to facilitate

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2021Provider & Pharmacy Directory

Details: Health Plans for certain services and items, such as elective hospital admissions, MRI/PET scans, etc. For a complete List of the services that may require Ultimate Health Plans’ approval in advance, please refer to your Evidence of Coverage. Your PCP selection may limit the specialists you can see.

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List of Covered Drugs

Details: A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription

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UHP Provider Manual Version Yr. 2019

Details: Ultimate Health Plans’ “Provider Manual” was developed for use by contracted Providers and their staff. It is included by reference in the contractual agreement (the “Agreement”) between Ultimate Health Plans and the Provider, and it is intended to establish guidelines to facilitate

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Prior Authorization Request

Details: Select EXPEDITED ONLY if the Member’s life, health, or ability to regain maximum function is jeopardized. For authorizations that need IMMEDIATE response (Urgent), …

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Ultimate Health Plans Formulary

Details: questions, please contact Ultimate Health Plans Member Services at 1-888-657-4170 or, for TTY users, 711, Monday through Sunday from 8 a.m. to 8 p.m. (during certain times of the year we may use alternative technologies to answer your call on weekends and Federal holidays), or visit www.chooseultimate.com.

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Ultimate Health Plans Enrollment Form

Details: Ultimate Health Plans is a Medicare Advantage plan and has a contract with the Federal government. I will need to keep my Medicare Parts A and B. I can be in only one Medicare Advantage plan at a time, and I understand that my enrollment in this plan will automatically end my

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2021 Member Rights and Responsibilities

Details: Ultimate Health Plans is Accredited by the National Committee for Quality Assurance (NCQA). As an NCQA-accredited health plan we are required to distribute a special rights and responsibilities statement. Ultimate Health Plans Members have: • A right to receive information about the organization, its services, its practitioners and providers and

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UHP Provider & Pharmacy Directory for May 2021

Details: Health Plans for certain services and items, such as elective hospital admissions, MRI/PET scans, etc. For a complete List of the services that may require Ultimate Health Plans’ approval in advance, please refer to your Evidence of Coverage. Your PCP selection may limit the specialists you can see.

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Chronic Special Needs Plan (CSNP) Pre-Qualificiation Form

Details: Ultimate Health Plans offers Special Needs Plans (SNPs) designed for people with certain chronic or disabling conditions, Diabetes and Cardiovascular Disease (CVD). You may be eligible to join one of our chronic-care SNPs if you can answer YES to any of the questions below. We will verify the presence of the chronic condition with your

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2020 summary of benefits

Details: Summary of Benefits Ultimate Health Plans www.ChooseUltimate.com. Toll-free: 1-855-858-7526 / TTY: 711 . your benefits and cost sharing. Premium and Benefits Advantage Care by Ultimate (019-1) and (019-2) Diagnostic Services/Labs/Imaging •Lab services •Outpatient X …

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Terms of Use and Privacy Policy for Ultimate Health Plans

Details: The information contained in this site is general in nature and is intended for educational purposes only. It is not a substitute for the advice of healthcare professionals. If you have specific healthcare needs, or for complete health information, please see a doctor or other healthcare provider.

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2020 summary of benefits

Details: Ultimate Health Plans will reduce your Medicare Part B premium by up to $110.00 per month. This plan does not have a deductible. $2,800 You pay : $125 : copay per day for days 1 through 5 You pay $0 copay per day for days 6 through 90 You pay : $25: copay per visit for Ambulatory Surgical Center services You pay $150 copay per visit for

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Ultimate Health Plans 2021 Chronic Special Needs Plan

Details: Ultimate Health Plans offers Special Needs Plans (SNPs) designed for people with certain chronic or disabling conditions: Diabetes Mellitus, Cardiovascular Disease (CVD), Chronic Heart Failure (CHF), Chronic Lung and Disorder/COPD. You may be eligible to join one of our chronic -care SNPs if you can answer YES to any of the questions below.

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Request for Redetermination of Medicare Prescription Drug

Details: health, we will automatically give you a decision within 72 hours. If you do not obtain your prescriber's support for an expedited appeal, we will decide if your case requires a fast decision. You cannot request an expedited appeal if you are asking us to pay you back for a

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Health Insurance Portability and Accountability Act (HIPAA

Details: health insurance portability and accountability act (hipaa) notice of privacy practices. this notice describes how medical/protected health information about you may be used and disclosed and how you can access this information. please review it carefully. ultimate health plans, inc. is a covered entity under hipaa law.

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UHP Provider & Pharmacy Directory for November 2020

Details: Ultimate Health Plans for certain services and items, such as elective hospital admissions, MRI/PET scans, etc. For a complete list of the services that may require Ultimate Health Plans’ approval in advance, please refer to your Evidence of Coverage. Your …

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January 1 – December 31, 2021 Evidence of Coverage

Details: Your Medicare Health B enefits and Services and Prescription Drug Coverage as a Member of: Premier by Ultimate (HMO) H2962-013-4, Citrus County. This booklet gives you the details about your Medicare health care and prescription drug coverage from January 1 – December 31, 2021. It explains how to get coverage for the health

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Fraud, Waste and Abuse

Details: Sell you a non-health related product, like an annuity or life insurance policy, while trying to sell you a Medicare health or drug plan. Make an appointment to tell you about their plan unless you agree in writing or through a recorded phone discussion …

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Acclaim by Ultimate (HMO) Elite by Ultimate (HMO)

Details: Medicare, the State Health Insurance Assistance Program (SHIP), the Quality Improvement Organization, Social Security, Medicaid (the state health insurance program for people with low incomes), programs that help people pay for their prescription drugs, and …

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2021 UHP Summary of Benefits

Details: Ultimate Health Plans will reduce your Medicare . Part B premium by up to. $110.00 per month. This plan . does not. have a deductible. $2,800. You pay . $125 . copay per day for days 1 through 5 You pay . $0 . copay per day for days 6 through 90 You pay . $25. copay per visit for . Ambulatory Surgical Center. services You pay . $195 . copay per

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