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Thank you for trusting FHK with your Medicare insurance needs

Dental Network: 877-370-4876

Customer Service line: 800-643-4845

Over-the-counter (OTC) credit:
Solutran
1-833-845-8798
myuhcmedicare.com/HWP

UnitedHealthcare Hearing
1-855-523-9355
UHCHearing.com/Medicare

Prescription drug home delivery
OptumĀ® Home Delivery Pharmacy
1-877-889-6358
myAARPMedicare.com

Find A Doc: uhc.com/find-a-doctor

Gym Membership Link: UHCrenewactive.com

UnitedHealthcare
Vision network- Call 1-877-370-4876 or myuhcvision.com

For a complete listing of benefits, please click here to download the Summary of Benefits for 2025

2024

2025

Medicare Advantage UHC WI-0010

Medicare Advantage UHC WI-0010

H5253-004

H5253-004

Southeastern

Southeastern

Premium

$29

$34

Primary Doctor

$0

$0

Specialist

$35

$35

Physical Therapy

$20

$25

Urgent Care

$40

$65

Hospital

$285 days 1-6

$275 days 1-6

MOOP Cap

$3,800

$3,800

Outpatient Surgery

$285 / $235 ASC

$275 / $175 ASC

Ambulance

$275

$275

Emergency

$135

$140

Lab Services

$0

$0

X-Rays

$15

$15

Complex Diagnostic

$115

$150

DME

20%

20%

Chemo/Part B

20%

20%

Part D

$0 / $10 / $47 / $100

$0 / $5 / $47 / $100

90-100 Day- Mailorder

$0 / $0 / $131 / $290

$0 /$0 / $131 / NA

Part D Deductible

$0

$340

(applies to tiers 3,4,5)

Skilled Nursing

$0 days 1-20
$203 days 21-100

$0 days 1-20
$203 days 21-100

Hearing Aid

$99 – $1,249

$99 – $1,249

OTC

$50 / quarter

$50 / quarter

Gym Membership

uhcrenewactive.com

uhcrenewactive.com

Dental

$1,500

$1,500

Dental Network

Any / UHC

Any / UHC

Vision

$250 Eyewear credit
Bi/Trifocals, standard
Progressive lens – 0$

$300 credit / 2 years
Bi/Trifocals, standard
Progressive lens – 0$

2024

2025

Med Adv-0010

Med Adv-0010

H5253-004

H5253-004

Southeastern

Southeastern

Premium

$29

$34

Primary Doctor

$0

$0

Specialist

$35

$35

Physical Therapy

$20

$25

Urgent Care

$40

$65

Hospital

$285
days 1-6

$275
days 1-6

MOOP Cap

$3,800

$3,800

Outpatient Surgery

$285 / $235 ASC

$275 / $175 ASC

Ambulance

$275

$275

Emergency

$135

$140

Lab Services

$0

$0

X-Rays

$15

$15

Complex Diagnostic

$115

$150

DME

20%

20%

Chemo/Part B

20%

20%

Part D

$0 / $10 / $47 / $100

$0 / $5 / $47 / $100

90-100 Day- Mailorder

$0 /$0 / $131 / $290

$0 / $0 / $131 / NA

Part D Deductible

$0

$340

(applies to tiers 3,4,5)

Skilled Nursing

$0 days 1-20
$203 days 21-100

$0 days 1-20
$203 days 21-100

Hearing Aid

$99 – $1,249

$99 – $1,249

OTC

$50 / quarter

$50 / quarter

Gym Membership

uhc renew active

uhc renew active

Dental

$1,500

$1,500

Dental Network

Any / UHC

Any / UHC

Vision

$250 Eyewear credit
Bi/Trifocals, standard
Progressive lens – 0$

$300 credit / 2 years
Bi/Trifocals, standard
Progressive lens – 0$

Thank you for trusting FHK with your Medicare insurance needs

Dental Network: 877-370-4876

Customer Service line: 800-643-4845

Over-the-counter (OTC) credit:
Solutran
1-833-845-8798
myuhcmedicare.com/HWP

UnitedHealthcare Hearing
1-855-523-9355
UHCHearing.com/Medicare

Prescription drug home delivery
OptumĀ® Home Delivery Pharmacy
1-877-889-6358
myAARPMedicare.com

Find A Doc: uhc.com/find-a-doctor

Gym Membership Link: UHCrenewactive.com

UnitedHealthcare
Vision network- Call 1-877-370-4876 or myuhcvision.com

For a complete listing of benefits, please click here to download the Summary of Benefits for 2025

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