We would like to show you a description here but the site won’t allow us. 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details This page features plan details for 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H5322 – 025 – 0 available in Select Counties in Texas. IMPORTANT : This page has been updated with plan and premium data for 2023. Maximum 3 visits every year. Copayment for Fluoride Treatment $0.00. Maximum 2 visits every year. Copayment for Dental X-Rays $0.00. Maximum 1 visit (Please see Evidence of Coverage for details) Maximum Plan Benefit of $3000.00 every year for Preventive and Non-Medicare Covered Comprehensive combined. Edit your h5322 025 form form online. Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more. Add your legally-binding signature. Draw or type your signature, upload a signature image, or capture it with your digital camera. Email, fax, or share your h5322 025 form form via URL. Number of Members enrolled in this plan in (H5322 - 025): 48,964 members : Plan’s Summary Star Rating: 5 out of 5 Stars. This plan qualifies for the 5-star rating Special Enrollment period. Read more. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. UnitedHealthcare Dual Complete (H5322-025) • Submit claims to WellMed. WellMed will reimburse you for the member’s medical services. UnitedHealthcare will reimburse you for the applicable member cost s hare. Sep 1, 2023 · UnitedHealthcare Dual Complete (HMO-POS D-SNP) You're viewing plan details for. 27053 Alamance County. Update your ZIP Code to view accurate plan details for your area. Monthly Premium. $ 0 - $ 38.40. Primary Care Provider. $ 0 copay - 20 % of the cost. Out-of-Pocket Maximum. Number of Members enrolled in this plan in (H5322 - 025): 25,188 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details Plan ID: H5322-025-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plan for Texas. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plan for Texas. Check eligibility, explore benefits, and enroll today. Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plan for Texas. Check eligibility, explore benefits, and enroll today. Hmm … it looks like your browser is out of date. Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of our plan This document gives you the details about your Medicare health care and prescription drugNumber of Members enrolled in this plan in (H5322 - 025): 48,964 members : Plan’s Summary Star Rating: 5 out of 5 Stars. This plan qualifies for the 5-star rating Special Enrollment period. Read more. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. 2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details Apr 1, 2023 · -060 002 Cigna TotalCare (HMO D SNP) H4590-025-AARP Medicare Advantage SecureHorizons (HMO) H4513-061-002 -Cigna Preferred Medicare (HMO) H4590-033- UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP) Premium:$25.1. This page features plan details for 2022 UnitedHealthcare Dual Complete (HMO D-SNP) H5322 – 025 – 0 available in Select Counties in Texas. IMPORTANT: This page features the 2022 version of this plan. See the 2023 version using the link below: 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H5322 - 025 - 0. Inpatient hospital-acute: In-network: $0 or $1,556 per stay $0 per day for days 91 and beyond Out-of-network: Not Applicable Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay Out-of-network: Not Applicable. Occupational therapy services: In-network: 0% or 20% coinsurance Out-of-network: No Data Physical therapy and speech and ... Learn more about the UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plan for Texas. Check eligibility, explore benefits, and enroll today.Apr 1, 2023 · -060 002 Cigna TotalCare (HMO D SNP) H4590-025-AARP Medicare Advantage SecureHorizons (HMO) H4513-061-002 -Cigna Preferred Medicare (HMO) H4590-033- UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP) A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Edit your h5322 025 form form online. Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more. Add your legally-binding signature. Draw or type your signature, upload a signature image, or capture it with your digital camera. Email, fax, or share your h5322 025 form form via URL. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify ... 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Webb, Texas Click to see other locations. Plan ID: H5322 - 025 - 0 Click to see other plans. Member Services: 1-866-944-4983 TTY users 711.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Plan Benefits Explained VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.UnitedHealthcare offers Texas 2023 UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. Jan 1, 2023 · Summary of Benefits 2023 UnitedHealthcare Dual Complete® LP (HMO-POS D-SNP) H5322-031-000 Look inside to take advantage of the health services and drug coverages the plan provides. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Brazos, Texas Click to see other locations. Plan ID: H5322 - 025 - 0 Click to see other plans. Member Services: 1-866-944-4983 TTY users 711.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details The UnitedHealthcare Dual Complete (HMO D-SNP) (H5322 - 025) currently has 35,217 members. There are 259 members enrolled in this plan in Hood, Texas. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4.5 stars. The detail CMS plan carrier ratings are as follows: 2020 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Plan Benefits Details H4590-033- UnitedHealthcareDual Complete Plan 2 (HMO D-SNP) H4513-009 - Cigna Fundamental Medicare (HMO) H4590-803-Group Retiree Plan(s) H4527-013-AARP Medicare Advantage (HMO) 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: Apr 1, 2023 · -060 002 Cigna TotalCare (HMO D SNP) H4590-025-AARP Medicare Advantage SecureHorizons (HMO) H4513-061-002 -Cigna Preferred Medicare (HMO) H4590-033- UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP) Jan 1, 2023 · UnitedHealthcare Dual Complete® (HMO-POS D-SNP) Premiums and Benefits In-Network Out-of-Network Monthly Plan Premium $35.90 Annual Medical Deductible Your deductible is $233 per year for covered medical UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. 2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Plan Benefits Explained H5322 - 025 - 0. 1-866-944-4983 TTY users 711. — This plan information is for research purposes only. — Click here to see plans for the current plan year. 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO D-SNP) benefit details. Emergency care/Urgent care. • Emergency: $0 or $90 copay per visit (always covered) • Urgent care: $0 or $65 copay per visit (always covered) Inpatient hospital coverage. • In 2020 the amounts for each benefit period are $0 or: $1,408 deductible for days 1 through 60. $352 copay per day for days 61 through 90. 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details Number of Members enrolled in this plan in (H5322 - 025): 9,816 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ... Inpatient hospital-acute: In-network: $0 or $1,556 per stay $0 per day for days 91 and beyond Out-of-network: Not Applicable Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay Out-of-network: Not Applicable. Occupational therapy services: In-network: 0% or 20% coinsurance Out-of-network: No Data Physical therapy and speech and ... UnitedHealthcare offers Texas 2023 UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.VDOMDHTMLad>. 301 Moved Permanently. 301 Moved Permanently. Microsoft-Azure-Application-Gateway/v2.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details HHSC approved Medicare Advantage and Dual eligible Plans 01/01/2023-12/31/2023 Medicare Advantage Plan HHSC Contract Number CMS Code Plan ID Plan Name Plan ID: H5322-025-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium H5322 - 025 - 0. 1-866-944-4983 TTY users 711. — This plan information is for research purposes only. — Click here to see plans for the current plan year. 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048 or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO D-SNP) benefit details. Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Jan 1, 2023 · 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5322_025_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for complete list of covered services, limitations and exclusions. Emergency care/Urgent care. • Emergency: $0 or $90 copay per visit (always covered) • Urgent care: $0 or $65 copay per visit (always covered) Inpatient hospital coverage. • In 2020 the amounts for each benefit period are $0 or: $1,408 deductible for days 1 through 60. $352 copay per day for days 61 through 90. Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Plan ID: H5322-025-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium 2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details Number of Members enrolled in this plan in (H5322 - 025): 35,217 members : Plan’s Summary Star Rating: 4.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 5 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ... Number of Members enrolled in this plan in (H5322 - 025): 25,188 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... Mar 13, 2023 · Hospitalization Coverage. Inpatient hospital-acute: In-network: $0 or $1,556 per stay. $0 per day for days 91 and beyond. Out-of-network: Not Applicable. Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay. Out-of-network: Not Applicable. 2023 UnitedHealthcare Dual Complete Plan Benefit Flyer H5322-025-000 no QMB card Subject: UnitedHealthcare Dual Complete additional benefit overview for health care professionals. Created Date: 20221229012412Z Mar 13, 2023 · Hospitalization Coverage. Inpatient hospital-acute: In-network: $0 or $1,556 per stay. $0 per day for days 91 and beyond. Out-of-network: Not Applicable. Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay. Out-of-network: Not Applicable. Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details H5322-025-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5322_025_000_2023_M 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: Premium:$25.1. This page features plan details for 2022 UnitedHealthcare Dual Complete (HMO D-SNP) H5322 – 025 – 0 available in Select Counties in Texas. IMPORTANT: This page features the 2022 version of this plan. See the 2023 version using the link below: 2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP) H5322 - 025 - 0. 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Star Rating Details TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete LP (HMO-POS D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify ... H4590-033- UnitedHealthcareDual Complete Plan 2 (HMO D-SNP) H4513-009 - Cigna Fundamental Medicare (HMO) H4590-803-Group Retiree Plan(s) H4527-013-AARP Medicare Advantage (HMO) UnitedHealthcare offers Texas 2023 UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools. 2021 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO D-SNP) Location: Brazos, Texas Click to see other locations. Plan ID: H5322 - 025 - 0 Click to see other plans. Member Services: 1-866-944-4983 TTY users 711. Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 Área de servicio: Texas - condados de Anderson, Andrews, Angelina, Archer, Armstrong, Austin, Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 Área de servicio: Texas - condados de Anderson, Andrews, Angelina, Archer, Armstrong, Austin, Sep 26, 2022 · H5322-025-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5322_025_000_2023_M A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Inpatient hospital-acute: In-network: $0 or $1,556 per stay $0 per day for days 91 and beyond Out-of-network: Not Applicable Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay Out-of-network: Not Applicable. Occupational therapy services: In-network: 0% or 20% coinsurance Out-of-network: No Data Physical therapy and speech and ... UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll. Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage
Inpatient hospital-acute: In-network: $0 or $1,556 per stay $0 per day for days 91 and beyond Out-of-network: Not Applicable Inpatient hospital psychiatric: In-network: $0 or $1,556 per stay Out-of-network: Not Applicable. Occupational therapy services: In-network: 0% or 20% coinsurance Out-of-network: No Data Physical therapy and speech and ... . All time doubles leaders
H5322-025-000 Consulte esta guía y aproveche las coberturas de medicamentos y los servicios de salud que proporciona el plan. Llame a Servicio al Cliente o visite el sitio web para obtener más información sobre el plan. Llamada gratuita 1-844-560-4944, TTY 711 8 a.m. a 8 p.m., hora local, los 7 días de la semana UHCCommunityPlan.com 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5322_025_000_2023_M Summary of Benefits January 1st, 2023 - December 31st, 2023 This is a summary of what we cover and what you pay. Review the Evidence of Coverage (EOC) for complete list of covered services, limitations and exclusions.2022 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Plan Benefits Details 2023 Medicare Advantage Plan Details. Medicare Plan Name: UnitedHealthcare Dual Complete (HMO-POS D-SNP) Location: Webb, Texas Click to see other locations. Plan ID: H5322 - 025 - 0 Click to see other plans. Member Services: 1-866-944-4983 TTY users 711. 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: Number of Members enrolled in this plan in (H5322 - 025): 25,188 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: Insufficient data to rate this plan. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split ... UnitedHealthcare offers UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about steps to enroll.Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Guía de Inscripción 2023 Aproveche todo lo que su plan Medicare Advantage tiene para ofrecer UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 Área de servicio: Texas - condados de Anderson, Andrews, Angelina, Archer, Armstrong, Austin, 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the UnitedHealthcare Dual Complete (HMO SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: UnitedHealthcare offers Texas 2023 UnitedHealthcare Dual Complete® (HMO-POS D-SNP) H5322-025-000 plans for Texas and eligible counties. This plan gives you a choice of doctors and hospitals. Learn about lookup tools.Number of Members enrolled in this plan in (H5322 - 025): 9,816 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: 5 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 4 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ... Y0066_EOC_H5322_025_000_2023_C. OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 – December 31, 2023 Evidence of Coverage Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of our plan This document gives you the details about your Medicare health care and prescription drugSep 26, 2022 · H5322-025-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-560-4944, TTY 711 8 a.m.-8 p.m. local time, 7 days a week UHCCommunityPlan.com Y0066_SB_H5322_025_000_2023_M Plan ID: H5322-025-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium 2021 UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 in TX Plan Benefits Details .