Preferred Care Network Medicare Advantage Special Needs Plans (SNPs) are HMO plans and HMO-POS in Miami-Dade and Broward counties. These plans combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional benefits and services designed to meet the unique needs of identified Medicare consumer populations.
The Preferred Care Network Dual Eligible SNP plans is intended for consumers eligible for Medicare & Medicaid benefits. This plan requires referrals for specialty care.
The Preferred Care Network Chronic Condition SNP plan provides specialized benefits and services for Medicare beneficiaries with chronic conditions such as diabetes, heart failure and/or cardiovascular disorders. This plan requires referrals for specialty care.
Health Maintenance Organization (HMO) plans have a defined network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies.
Point of Service (HMO-POS) plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Some POS plans only cover out-of-network dental care.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare.
Coverage options may vary depending upon your location. To learn more about a plan in your service area, go to PCNHealth.com.
To learn more about Medicare Part D prescription drug coverage or to access related forms, please review the Prescription Drug Resources materials available on PCNHealth.com. This section contains information and forms for direct member reimbursement, medication prior authorization, and the prescription drug transition process.