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UHC Nursing Home Plan IN-F001 (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Nursing Home Plan IN-F001 (PPO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Nursing Home Plan IN-F001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan IN-F001 (PPO I-SNP) is a PPO I-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Indiana. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Nursing Home Plan IN-F001 (PPO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Nursing Home Plan IN-F001 (PPO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Nursing Home Plan IN-F001 (PPO I-SNP).
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 Nursing Home Plan IN-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $24.60. 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 $615.00 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 combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Nursing Home Plan IN-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for covered medications before the plan begins to pay its share. Specific drug tier details, including individual copayments and coinsurance rates, are currently unavailable for this plan. Understanding this $615 deductible is essential when evaluating the overall out-of-pocket costs of this Medicare Advantage plan. Since additional drug tier details are not provided, this deductible is the primary cost metric available for assessing your prescription drug expenses.
Additional Benefits
The UHC Nursing Home Plan IN-F001 (PPO I-SNP) offers comprehensive medical coverage, featuring no copays for primary care, specialist visits, and home health care, though some services require up to 20% coinsurance. Inpatient hospital stays carry an $1,800 copay per stay with no coinsurance, while skilled nursing facility care is covered with no copay and no coinsurance for up to 100 days. Emergency room visits require a $115 copay, which is waived if you are admitted, while outpatient services and diagnostic labs are accessible with no copay. This plan also includes valuable routine benefits, such as dental care with no copay or coinsurance up to a $2,000 annual limit and routine vision and hearing exams with no copay and 20% coinsurance. Additionally, members benefit from no copays or coinsurance on over-the-counter items, home safety devices, and up to 48 one-way transportation trips per year to approved locations. Prescription hearing aids and eyewear are also covered up to generous allowance limits with no copay or coinsurance.
Inpatient Hospital See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers inpatient acute and psychiatric hospital services with a $1,800 copay per Medicare-covered stay and no coinsurance, subject to prior authorization. This benefit is partially covered as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copays, though prior authorization is required for these benefits. Depending on the specific service, coinsurance ranges from no coinsurance up to 20% for outpatient hospital, ambulatory surgical center, and substance abuse sessions, while outpatient blood services carry a 20% coinsurance with no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no coinsurance and a copay ranging from no copay to $40, but worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers primary care, specialist, and mental health services with no copay and coinsurance ranging from no coinsurance to 20%. Physical, occupational, and speech therapy services, along with telehealth and opioid treatment, are covered with no copay and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and diabetes training, while a 20% coinsurance and no copay apply to glaucoma screenings, digital rectal exams, and EKGs. Additional benefits are partially covered, including home and bathroom safety devices with no copay and no coinsurance, though services like fitness benefits, health education, and personal emergency response systems are not covered.
Hearing Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) offers partially covered hearing services with no deductible, including one routine hearing exam annually for no copay and a 20% coinsurance, while hearing aid fittings and evaluations are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to a $2,200 limit every two years, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) offers partially covered vision services, which include one routine eye exam annually with no copay and a 20% coinsurance, though other eye exam services are not covered. Covered eyewear has no copay and no coinsurance up to a $200 yearly limit for contact lenses, eyeglass lenses, and eyeglass frames, but upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) offers partially covered dental services with no copay and no coinsurance for preventive and comprehensive care up to a $2,000 annual maximum, excluding orthodontics which are not covered. Medicare-covered dental services are also covered with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by the UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copay and a 20% coinsurance for durable medical equipment, medical supplies, and diabetic equipment. Prosthetic devices are also covered with no copay and a coinsurance ranging from no coinsurance up to 20%, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copay and no coinsurance for lab services, diagnostic procedures, and X-rays. Prior authorization is required for all services, with diagnostic and therapeutic radiological services also carrying no minimum copay or coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Nursing Home Plan IN-F001 (PPO I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the UHC Nursing Home Plan IN-F001 (PPO I-SNP) are covered with no copay and require prior authorization, though only some services are covered. Specifically, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Nursing Home Plan IN-F001 (PPO I-SNP) for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. While a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Nursing Home Plan IN-F001 (PPO I-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services under this category are not covered.
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