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UHC Nursing Home Plan MO-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 MO-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 MO-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan MO-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 Missouri. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that UHC Nursing Home Plan MO-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 MO-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 MO-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 MO-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 $590.00 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 $7800.00 (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 $7800.00 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 MO-F001 (PPO I-SNP) has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered Part D drugs. The plan's premium may be reduced if you qualify for the low-income subsidy, and the monthly premium is $51.00 with LIS.
Additional Benefits
The UHC Nursing Home Plan MO-F001 (PPO I-SNP) offers a range of benefits with varying costs. Inpatient hospital stays have a $2,000 copay, while outpatient services often involve coinsurance. Emergency services have a $110 copay, and urgently needed services range from no copay to a $40 copay. The plan covers many services with no copay, including primary care visits, home health services, and many dental services. Hearing aids are covered with a $2,200 annual benefit, and vision services include eye exams and coverage for eyewear. Additional benefits include ambulance and transportation services, and coverage for durable medical equipment and supplies.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP), but each stay requires a $2,000 copay. Additional days and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services, are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP). Outpatient hospital services have a coinsurance of 0% to 20%, observation services have a 20% coinsurance, outpatient substance abuse services (individual and group sessions) have a coinsurance of 0% to 20%, and outpatient blood services have a coinsurance of 0% to 20%.
Partial Hospitalization See details
Partial Hospitalization is covered, with no copay required. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP). Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location are covered with no copay for up to 18 one-way trips per year via taxi or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with a copay of $110, and no coinsurance. Urgently Needed Services are covered with a copay between $0 and $40, and no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers primary care physician services with no copay, chiropractic services with a 0-20% coinsurance, and occupational therapy services with no copay or coinsurance. The plan also covers physician specialist services with a 0-20% coinsurance, mental health specialty services with a 0-20% coinsurance, podiatry services with a 0-20% coinsurance, and other health care professional services with no copay. Additionally, the plan covers psychiatric services with a 0-20% coinsurance, physical therapy and speech-language pathology services with no copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
The UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers preventive services, including an annual physical exam with no copay. Additional preventive services include a copay, and the plan also covers kidney disease education services with no copay. Other preventive services include a coinsurance for some services, such as glaucoma screenings, and a copay for some services, such as barium enemas.
Hearing Services See details
Hearing Services include routine hearing exams with no copay and at most 20% coinsurance, and prescription hearing aids with a $2,200 annual benefit, no copay, and a limit of 2 per year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services includes coverage for eye exams with a coinsurance of 0% - 20% for routine eye exams, and coverage for eyewear with a $300 combined maximum benefit per year for contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for a variety of services, with no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventative dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery. Medicare Dental Services have a coinsurance between 0% and 20%, while orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B insulin drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. Medicare Part B insulin drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP) and require prior authorization. You will pay between 0% and 20% coinsurance for these services.
Medical Equipment See details
The UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers Durable Medical Equipment with a 20% coinsurance, and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, and Lab Services with no copay. Diagnostic Radiological Services and Therapeutic Radiological Services are covered with a coinsurance of up to 20%, and Outpatient X-Ray Services are covered with no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP), but the specific services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with prior authorization required. For days 1-100, there is no copay, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with no copay, while acupuncture, meal benefits, 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.
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