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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 2026, 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 2026.
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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $270.00 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 features an annual prescription drug deductible of $270. Members enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs filled at standard pharmacies for 1-month or 3-month supplies, or through 3-month standard mail orders. This coverage helps lower the out-of-pocket costs for daily maintenance medications. For brand-name and specialty drugs, the plan utilizes coinsurance rather than fixed copays. Tier 3 preferred brand drugs require an 18% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs have a 40% and 30% coinsurance respectively for 1-month supplies. These percentage-based costs apply to both standard pharmacy fills and standard mail orders.
Additional Benefits
The UHC Medicare Advantage NV-001P (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, primary care doctor visits, specialist appointments, and home health services. Outpatient hospital care and annual preventive exams also feature no copay, while emergency room visits carry a $150 copay that is waived upon hospital admission. Diagnostic services are highly affordable, requiring no copay for laboratory tests and a low $5 copay for outpatient X-rays. For ancillary benefits, the plan includes preventive dental services with no copay up to a $1,250 annual maximum, along with routine vision and hearing exams with no copay. Prescription hearing aids require copays between $199 and $1,249, whereas durable medical equipment features a 20% coinsurance and no copay. Furthermore, members benefit from over-the-counter items and up to 12 one-way transportation trips per year with no copay or coinsurance.
Inpatient Hospital See details
UHC Medicare Advantage NV-001P (HMO-POS) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, though referrals and prior authorization are required. While unlimited additional days for acute care are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Medicare Advantage NV-001P (HMO-POS) covers outpatient services with no coinsurance and no copay for outpatient hospital, observation, ambulatory surgical center, and blood services. Outpatient substance abuse services are also covered with no coinsurance, featuring a $10 copay for group sessions and a copay ranging from $0 to $15 for individual sessions.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Medicare Advantage NV-001P (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by UHC Medicare Advantage NV-001P (HMO-POS), requiring a $150 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Medicare Advantage NV-001P (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $20 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits under the UHC Medicare Advantage NV-001P (HMO-POS) plan are covered with no copay and no coinsurance for primary care, specialist, therapy, telehealth, podiatry, and opioid treatment services. Mental health and psychiatric services require no coinsurance, with copays ranging from $0 to $15 for individual sessions and a $10 copay for group sessions. Chiropractic services are partially covered, as routine and other chiropractic services are not covered under this plan.
Preventive Services See details
UHC Medicare Advantage NV-001P (HMO-POS) provides preventive services, such as annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness benefits and home safety devices, while services like health education, nutritional therapy, and in-home support are not covered.
Hearing Services See details
UHC Medicare Advantage NV-001P (HMO-POS) offers partially covered hearing services with no deductibles and no coinsurance. Routine hearing exams are covered with no copay, but fitting evaluations and inner, outer, or over-the-ear prescription hearing aids are not covered. Covered OTC and prescription hearing aids are limited to two per year with no coinsurance and copays ranging from $199 to $1,249.
Vision Services See details
UHC Medicare Advantage NV-001P (HMO-POS) provides partially covered vision services with no deductible and no coinsurance, offering one routine eye exam per year with no copay, though other eye exam services are not covered. For eyewear, the plan offers no coinsurance up to a $200 combined maximum benefit every two years, covering contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services for the UHC Medicare Advantage NV-001P (HMO-POS) are partially covered, offering preventive and diagnostic care with no copay and no coinsurance up to a $1,250 annual maximum. Comprehensive treatments are available with no copay and a 50% coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Medicare Advantage NV-001P (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while covered Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the UHC Medicare Advantage NV-001P (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization and referrals are required to access this benefit.
Medical Equipment See details
UHC Medicare Advantage NV-001P (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay, diabetic therapeutic shoes and inserts carry a 20% coinsurance, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
UHC Medicare Advantage NV-001P (HMO-POS) covers diagnostic and radiological services with prior authorization and referral requirements. Diagnostic tests require a $20 copay and no coinsurance, lab and diagnostic radiological services have no copay, outpatient X-rays carry a $5 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
UHC Medicare Advantage NV-001P (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the UHC Medicare Advantage NV-001P (HMO-POS) plan, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. While the benefit technically features no copay and no coinsurance, prior authorization and referrals are required.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by UHC Medicare Advantage NV-001P (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Medicare Advantage NV-001P (HMO-POS) covers select other services, including over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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