CTPF 2027 MEDICARE HEALTH INSURANCE HANDBOOK
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UnitedHealthcare Group Medicare Advantage PPO 
with Express Scripts by Evernorth Health Services® (PDP) 
for CTPF Medicare Advantage plan
OUTPATIENT SERVICES
Chemotherapy, Radiation 100% after deductible
Emergency Room $50
Lab/X-Ray 100% after deductible
Speech, Physical & Occupational Therapy, 
Outpatient Rehab 100% after deductible
Surgery 100% after deductible
Urgent Care 100% after deductible
PROFESSIONAL & OTHER SERVICES
Ambulance 100% after deductible
Allergy Shots 100% after deductible
Chiropractic Visits 100% after deductible (unlimited visits); 
Medicare covered services
Dental 100% after deductible; Medicare covered services only
Diabetic Part B Covered Supplies 100% covered
Hearing 
Medicare-covered Services: 100% after deductible
Routine (Non-Medicare) Services: $0 copay routine exam       
Hearing Aids: $1,000 allowance purchased in network 
through UnitedHealthcare Hearing every three years
Home Health Services 100% after deductible
Physician Office Visits 100% after deductible
Preventive Care (physicals, diagnostics, some 
immunizations) 100% covered  (1 physical per plan year)
Prosthetic Devices, Med. Equip 100% after deductible
Podiatry 
Medicare-covered Services 100% after deductible
Routine (Non-Medicare) Services 100% after deductible, 
6 visits per year
Renal Dialysis 100% after deductible
Transplants 100% after deductible
Vision Services 
Medicare covered Services: 100% after deductible; 
Eye Wear: $0 copay Medicare covered standard eyeglass 
lenses and frames after cataract surgery. 
Routine (Non-Medicare Covered) Services: $0 copay annual 
routine eye exam; $300 eye wear allowance every 12 months.
Extra Benefits (wellness, discounts)  $60/quarter over the 
counter products benefit, HouseCalls, Fitness Benefit, hearing 
aid discount, Wellness programs, Renew Rewards, Let’s Move 
and more. Contact carrier for more benefit details.
Humana Group Medicare HMO 
with Part D Pharmacy Medicare Advantage plan
OUTPATIENT SERVICES
Chemotherapy, Radiation
Chemotherapy: 100% after $50 copay outpatient hospital; 
$25 copay specialist’s office. Radiation: 100% outpatient 
hospital; 100% after $25 copay specialist’s office.
Emergency Room 
$50 copay emergency room; waived if admitted 
within 24 hours; applies for care outside US
Lab/X-Ray
100% covered; any applicable office visit copay may apply  
Speech, Physical & Occupational Therapy, 
Outpatient Rehab
100% per visit after $25-$40 copay 
(based on where services are rendered)
Surgery
$100    copay per visit in hospital
  $75    copay per visit in ambulatory surgical facility
Urgent Care 
  $25    copay
PROFESSIONAL & OTHER SERVICES
Ambulance $50 copay per date of service
Allergy Shots No copay
Chiropractic Visits $20 copay;                              
Medicare guidelines apply
Dental $25 copay (Medicare covered services only)
Diabetic Part B Covered Supplies 100% covered
Hearing $25 copay at PCP, $25 copay specialist, 
Medicare covered services only.
Home Health Services No copay (prior authorization 
required) excludes personal home care
Physician Office Visits                                          
$10 copay PCP,  $25 copay specialist
Preventive Care (physicals, diagnostics, 
immunizations) No copay
Prosthetic Devices, Med. Equip 10% at medical 
equipment provider or pharmacy
Podiatry $25 copay; Medicare covered services only
Renal Dialysis No copay in dialysis center; 20% at 
hospital
Transplants As any other disease at Medicare-
approved Humana National Transplant Network only 
Vision Services $25 copay; Medicare covered 
services only 
Extra Benefits (wellness, discounts) Contact carrier 
for extra benefit details.
Plan Comparisons: Medicare-Eligible Members

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