Gonzaba News for Agents

Hello, San Antonio Agents! I’m Roel Garces, Market Growth Manager with UnitedHealthcare. Our market growth team educates and supports agents in San Antonio, Corpus Christi, Austin, and Waco. We are committed to working together with you as partners and will continue to provide a vast, reliable network, easy-to-use agent platforms, and sustainable benefits that promote healthier lives for our members. As a leader in the Medicare Advantage market, we have our finger on the pulse of what impacts members as well as agents. In this ever-changing industry, our focus has always been providing our members with benefits that improve their health and giving you the knowledge and tools you need to be successful. We value your partnership and look forward to delivering high-quality benefits and service to our members together.

Here are our 2026 HMO Highlights:

UHC Dual Complete TX-S003 (HMO-POS D-SNP)
Full Dual Integrated Plan (Best Fit for QMB+, SLMB+, FBDE)

• Monthly Premium: $0.00
• MOOP: $0
• PCP: $0
• Specialist: $0
• Inpatient: $0
• ASC/Outpatient: $0
• Emergency/Urgent Care: $0
• Rx deductible: $0 Tier 1 $615 Tiers 2-5 ($0 with LIS)
• Rx copays: $0 Tier 1 Tiers 2-5 costs vary by LIS Level
• Dental: $2,500
• Vision: $200 annually for eyewear
• Hearing: $2,200 every 2 years
• Fitness Membership: YES
• OTC/Healthy Food/Utility Assistance: $181/mo.
• Transportation: 36 One-way trips

UHC Dual Complete TX-D004 (HMO-POS D-SNP)
Best Fit for QMB

• Monthly Premium: $0.00
• MOOP: $0 – $9,250
• PCP: 0% – 20%
• Specialist: 0% – 20%
• Inpatient: $0 – $2,230 unlimited days
• ASC/Outpatient: $0 – 20%/ $0 – 20%
• Emergency/Urgent Care: $0 – $115/ $0 – $40
• Rx deductible: $0 Tier 1-2 $137 Tiers 3-5 ($0 with LIS)
• Rx copays: $0 Tier 1-2 Tiers 3-5 costs vary by LIS Level
• Dental: $1,500
• Vision: $200 annually for eyewear
• Hearing: $1,500 every 2 years
• Fitness Membership: YES
• OTC/Healthy Food/Utility Assistance: $60/mo.
• Transportation: 24 One-way trips

AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS)

• Monthly premium: $0.00
• MOOP: $4,200
• PCP: $0 copay
• Specialist: $20 copay
• Inpatient: $150 copay for days 1-6
• ASC/Outpatient: $125/$150 copay
• Emergency/Urgent care: $150/$65
• Rx deductible: $0 Tier 1-2 $440 Tiers 3- 5
• Rx copays: $0/$0/$15/40%/28%
• Dental: $1000 annually (50% cost share)
• OTC: $25 per quarter
• Vision: $150 every 2 years
• Hearing: $199 – $1,249 (2 devices every year)
• Fitness Membership: YES

AARP Medicare Advantage Extras from UHC TX-28 (HMO-POS)

• Monthly premium: $0.00
• MOOP: $4,700
• PCP: $0 copay
• Specialist: $35 copay
• Inpatient: $325 for days 1-6
• ASC/Outpatient: $275/$325
• Emergency/Urgent care: $130/$50
• Advanced imaging: $0
• Rx deductible: $0 Tier 1-2 $520 Tiers 3-5
• Rx copays: $0/$10/19%/27%/27%
• Dental: $4,000
• OTC: $60 per quarter
• Vision: $200 every 2 years
• Hearing: $199 – $1,249
• Fitness Membership: YES
• Transportation: 12 One-way trips

AARP Medicare Advantage from UHC TX-0043 (HMO-POS)

• Monthly premium: $27.00
• MOOP: $4,200
• PCP: $0 copay
• Specialist: $20 copay
• Inpatient: $150 for days 1-6
• ASC/Outpatient: $125/$150
• Emergency/Urgent care: $150/$65
• Rx deductible: $0 Tiers 1-2 $440 Tiers 3-5
• Rx copays: $0/$0/15%/39%/28%
• Dental: $5,000 annually
• Vision: $250 every 2 years
• OTC: $60 per quarter
• Hearing: $199 – $1,249
• Transportation: 36 One-way trips
• Fitness Membership: YES

Complete Care TX-24 (HMO-POS C-SNP)

• Monthly premium: $0
• MOOP: $4,200
• PCP: $0 copay
• Specialist: $15 copay
• Inpatient: $195 for days 1-6
• ASC/Outpatient: $145/$195
• Emergency/Urgent care: $150/$65
• Rx deductible: $0 Tiers 1-2 $440 Tiers 3-5
• Rx copays: $0/$0/23%/44%/28%
• Dental: Preventive
• Vision: $300 every 2 years
• OTC: $48 per month
• Hearing: $199 – $1,249
• Transportation: 24 One-way trips
• Fitness Membership: YES