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UHC Medicare Advantage NV-001P (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage NV-001P (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Medicare Advantage NV-001P (HMO-POS) in 2025, please refer to our full plan details page.
UHC Medicare Advantage NV-001P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that UHC Medicare Advantage NV-001P (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Medicare Advantage NV-001P (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UHC Medicare Advantage NV-001P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $7.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $175.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $1900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The UHC Medicare Advantage NV-001P (HMO-POS) plan has a $175 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay no copay for preferred generic drugs at a standard pharmacy, and $47 for standard generic drugs at a standard pharmacy. For preferred brand drugs, the copay is $100, regardless of the pharmacy. For non-preferred drugs, you will pay 31% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The UHC Medicare Advantage NV-001P (HMO-POS) plan offers comprehensive coverage, including inpatient and outpatient hospital services with no copay. It also covers a range of other services, such as primary care, preventive services, hearing, vision, and dental, with varying cost-sharing structures. Some services require copays, like emergency services at $90, while others, like ambulance and transportation, have specific copays. This plan includes added benefits like coverage for hearing aids and eyewear, as well as services like home health and skilled nursing facilities. It's important to note that some services, such as partial hospitalization, dialysis, and durable medical equipment, may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with no copay for Medicare-covered stays and no coinsurance. Additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services have no copay. Individual outpatient substance abuse sessions have a copay between $0 and $15, while group sessions have a $10 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Medicare Advantage NV-001P (HMO-POS) plan with a $55 copay. Prior authorization and a doctor referral are required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services with a $200 copay, and transportation services with no copay. Transportation services to any health-related location is not covered, but transportation services to plan-approved health-related locations are covered for 12 one-way trips per year, using a taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Medicare Advantage NV-001P (HMO-POS) plan. Emergency Services have a $90 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $20 and no coinsurance. Worldwide Emergency Services include Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no copay and no coinsurance.
Primary Care See details
The UHC Medicare Advantage NV-001P (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, additional telehealth benefits, and opioid treatment program services have no copay, while individual mental health and psychiatric sessions have a copay between $0 and $15, and group mental health and psychiatric sessions have a $10 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and other preventive services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay; Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered. Fitness Benefit and Home and Bathroom Safety Devices and Modifications are covered with no copay, and Kidney Disease Education Services are covered with no copay.
Hearing Services See details
Hearing services include routine hearing exams with no copay, and prescription hearing aids, with a copay ranging from $199 to $1249, and OTC hearing aids with a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, with a combined maximum plan benefit of $200 every two years, and contact lenses are covered. Eyeglass lenses have a copay between $0 and $153, and eyeglass frames are covered with no copay.
Dental Services See details
The UHC Medicare Advantage NV-001P (HMO-POS) plan covers a variety of dental services, including oral exams, dental x-rays, and other preventative services with no copay. Prosthodontics, removable, and prosthodontics, fixed have a coinsurance of 0% - 50%, and some services require prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Prosthetic Devices also have a 20% coinsurance; Medical Supplies also have a 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, and outpatient X-ray services are covered with a copay of $20, and $5 respectively, while lab services have no copay. Diagnostic radiological services have a copay of at most $130 and therapeutic radiological services have a copay of at least $50.
Home Health Services See details
Home Health Services are covered by the UHC Medicare Advantage NV-001P (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Medicare Advantage NV-001P (HMO-POS), requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the "Other Services" benefit, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Over-the-counter items are covered with no copay, and the meal benefit is covered with no copay, but requires prior authorization.
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