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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 2026, 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 2026.
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 $43.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 $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 MO-F001 (PPO I-SNP) has an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered prescription medications before the plan starts to cover its share of the costs. Specific drug tier details, including individual copays and coinsurance rates, are not currently available for this plan. To determine your exact coverage and costs for specific medications, you should review the plan's formulary.
Additional Benefits
The UHC Nursing Home Plan MO-F001 (PPO I-SNP) offers robust medical coverage with many essential services featuring no copay, though specific coinsurance and copays do apply. For example, inpatient hospital stays require a $1,790 copay per benefit period with no coinsurance, whereas outpatient care and primary care visits generally have no copays and coinsurance up to 20%. Emergency room visits carry a $115 copay with no coinsurance, while skilled nursing facility care for days 1 through 100 is covered with no copay and no coinsurance. Routine vision exams, preventive dental, and home health services are covered with no copay, while diagnostic tests, dialysis, and durable medical equipment typically require a 20% coinsurance. Supplemental benefits include up to 18 one-way transportation trips per year, a $300 annual allowance for eyewear, and a $2,200 hearing aid benefit every two years with no copay and no coinsurance. Over-the-counter items are also fully covered with no copay and no coinsurance to support daily health needs.
Inpatient Hospital See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers inpatient acute and psychiatric hospital stays with a $1,790 copayment per benefit period and no coinsurance. Prior authorization is required for these services, and additional days or non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers outpatient services with no copays, while coinsurance ranges from no coinsurance up to 20% depending on the specific service. These covered benefits include outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers ambulance services with a 20% coinsurance and no copay for both ground and air transport, subject to prior authorization. Transportation services are partially covered, providing up to 18 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
UHC Nursing Home Plan MO-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 copay to a $40 copay and no coinsurance, while worldwide emergency services are not covered.
Primary Care See details
Primary care benefits under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) are generally covered with no copay and 0% to 20% coinsurance, although chiropractic services are not covered in practice. Covered services such as specialist visits, physical therapy, and mental health care require prior authorization, while telehealth and opioid treatment program services feature no copay and no coinsurance.
Preventive Services See details
Preventive Services under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) are partially covered, offering annual physical exams, kidney disease education, and home safety modifications with no copay and no coinsurance. Medicare-covered glaucoma screenings, digital rectal exams, and post-welcome visit EKGs require a 20% coinsurance, while diabetes self-management training has no copay; however, several supplemental benefits like fitness, health education, and in-home support are not covered.
Hearing Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) offers partially covered hearing services, featuring one annual routine hearing exam with a 20% coinsurance and no copay, though fitting and evaluation exams are not covered. Prescription hearing aids (excluding inner ear, outer ear, and over the ear types) and over-the-counter hearing aids are covered with no copay and no coinsurance, with a maximum benefit of $2,200 every two years for prescription devices.
Vision Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) partially covers vision services, offering one routine eye exam per year with no copay, a 20% coinsurance, and no deductible, while other eye exams are not covered. Eyewear is covered with no copay, no coinsurance, and a $300 annual limit for contact lenses, individual lenses, and frames, but upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the UHC Nursing Home Plan MO-F001 (PPO I-SNP), with Medicare-covered dental requiring no copay and a 20% coinsurance, and preventive services like cleanings, exams, fluoride, and X-rays offered with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, orthodontic, oral surgery, and other diagnostic dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry 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 under the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by the UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay and a 20% coinsurance, though some prosthetic devices may have no coinsurance. Prior authorization is required for these benefits, which include durable medical equipment, diabetic supplies, and therapeutic shoes.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests require a copay and a minimum 20% coinsurance, lab services require coinsurance with no copay, diagnostic radiology features no copay and no coinsurance, and therapeutic radiology and outpatient X-rays require a minimum 20% coinsurance with no copay.
Home Health Services See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Nursing Home Plan MO-F001 (PPO I-SNP) with no copay and prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan MO-F001 (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance. Prior authorization is required, but a prior three-day inpatient hospital stay is not, though additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services are partially covered by UHC Nursing Home Plan MO-F001 (PPO I-SNP), which offers over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this benefit.
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