UHC Nursing Home Plan NC-F001 (PPO I-SNP): Costs+Coverage H0710-034-0
UHC Nursing Home Plan NC-F001 (PPO I-SNP): Costs+Coverage H0710-034-0
Uncover the tailored benefits and costs of UHC Nursing Home Plan NC-F001 (PPO I-SNP), a 2025 Medicare Special Needs Plan crafted to support your specific healthcare requirements. This page provides a comprehensive look at the plan’s benefits and costs, helping you make an informed choice.
Delivery of healthcare services and costs by UnitedHealthcare® are different than Original Medicare. This private health insurance option may include additional benefits that are not provided by Medicare Part A and Part B.
- Doctor Visits
- Foot Care
- Chiropractic
- Urgent & Emergency
- Mental Health
- Rehab Services
- Equipment & Supplies
- Diag, Lab, Imaging
- Part B Drugs
- Dental
- Hearing Aids
- Vision
- Prescriptions
| Plan ID H0710-034-0 Overview | |
|---|---|
| Health Plan ID: | H0710-034-0 |
| Medicare Advantage Plan Type: | PPO I-SNP |
| Plan Year: | 2025 |
| Monthly Premium: | $51.20 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | 2,800.00 |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Basic, $590.00 deductible |
| Supplemental Benefits: | Vision, Hearing |
| Availability: | See List |
| Insured By: | UnitedHealthcare® |
| We're Here to Help You Enroll |
|---|
Health Plan Cost Sharing & Benefits
UHC Nursing Home Plan NC-F001 is a Preferred Provider Organization (PPO) plan. As a member of this {plan_type_2} plan, you typically access care through in-network providers, but you have the flexibility to see out-of-network providers if needed. Keep in mind that visits to non-network providers may result in higher out-of-pocket costs.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | $0 Copay |
| Specialist: | 20% Coinsurance Prior Authorization Required |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $110 Copay |
| Urgent care: | $40 Copay |
| Ground ambulance: | 20% Coinsurance |
| Inpatient hospital care: | $2,000.00 per stay |
| Skilled Nursing Facility: | $0.00 per day for days 1 through 100 |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | 20% Coinsurance Prior Authorization Required |
| Routine Foot Care: | $0 Copay Prior Authorization Required |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | 20% Coinsurance Prior Authorization Required |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | 20% Coinsurance |
| Outpatient group therapy: | 20% Coinsurance |
| Inpatient psychiatric hospital care: | $2,000.00 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $0 Copay Prior Authorization Required |
| Occupational therapy: | $0 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | 20% Coinsurance Prior Authorization Required |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | 20% Coinsurance Prior Authorization Required |
| Lab services: | $0 Copay Prior Authorization Required |
| Outpatient x-rays: | $0 Copay Prior Authorization Required |
| Diagnostic tests and procedures: | 20% Coinsurance Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | Not Covered |
| Oral exam | $0 Copay |
| Dental x-rays | $0 Copay |
| Cleaning | $0 Copay |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Not Covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | 20% Coinsurance |
| Routine eye exam (in-network) | $0 Copay Prior Authorization Required, 1 Every year |
| Eyewear benefits | Eyeglasses: No Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $300.00 Every year |
Prescription Drug Plan Costs & Benefits
Prescription Drug Plan Premium
The following table outlines the prescription drug plan premium details of this plan.
| Basic Part D Premium: | $51.20 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $51.20 |
| Low Income Premium Subsidy: | $51.22 |
| Low Income Premium Subsidy CMS Pays: | $51.20 |
| Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $590.00. This is the amount you must pay at the pharmacy before UnitedHealthcare® begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, UHC Nursing Home Plan NC-F001 has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Cost data not available. | |||
| *Deductible does not apply. | |||
CMS Rating Marks
The Centers for Medicare & Medicaid Services (CMS) annually rates Medicare Advantage {plan_type_2}s in nine key categories using a 5-star system. These ratings help you gauge the quality of care and service you might receive with this UnitedHealthcare® plan.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Not enough data available |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | Not enough data available |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
Eligibility for Enrollment in UHC Nursing Home Plan NC-F001
To enroll in UHC Nursing Home Plan NC-F001 , you must meet the following three criteria:
- You are eligible for Medicare;
- You reside within the plan’s service area; and
- You require the level of care typically provided in an institutional setting, such as a long-term care nursing facility, for 90 days or more.
This plan is for individuals living in a long-term care facility.
If you live at home and need a similar level of skilled care, you may qualify for an Institutional Equivalent Special Needs Plan (IE-SNP).
Important Enrollment Periods
After confirming your eligibility for UHC Nursing Home Plan NC-F001 , it’s essential to understand when you can enroll or make changes to your Medicare plan. The following enrollment periods are important to understand and mark on your calendar
- Initial Enrollment Period (IEP): Your first opportunity to enroll when you become eligible for Medicare.
- Annual Enrollment Period (AEP): The time each year when you can change your Medicare plan or enroll in a new one.
- Special Enrollment Periods (SEPs): Times outside of AEP when you can make changes due to specific circumstances, such as moving to a new area or losing other insurance coverage.
To get a deeper understanding of these enrollment periods, click here to learn more and stay informed about your Medicare choices.
Plan Availability
UHC Nursing Home Plan NC-F001 (H0710-034-0) is available in the following locations (click to open):
Contact UnitedHealthcare®
| Website: | UnitedHealthcare® Plan Page |
|---|---|
| Providers: | UnitedHealthcare® Providers Page |
| Formulary: | UnitedHealthcare® Formulary Page |
| Pharmacy: | UnitedHealthcare® Pharmacy Page |
| New Member Health Plan Help: | (888)834-3721 |
| New Member Health Plan TTY: | 711 |
| New Member Part D Help: | (888)834-3721 |
| New Member Part D TTY Users: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Plans Offered through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.