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UHC Nursing Home Plan TX-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 TX-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 TX-F001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan TX-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 Texas. 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 TX-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 TX-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 TX-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 TX-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 TX-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. This deductible is the amount you must pay out of pocket for your medications before your plan coverage kicks in. Specific drug coverage tier details, including individual copayments and coinsurance rates, are currently unavailable for this plan. To understand your exact medication costs, you will need to check the plan's formulary or contact the provider directly to see how your prescriptions are covered under the deductible.
Additional Benefits
The UHC Nursing Home Plan TX-F001 (PPO I-SNP) provides comprehensive medical coverage with many essential services featuring no copays. Inpatient hospital stays require a $1,400 copayment per benefit period with no coinsurance, while skilled nursing facility care for days 1 through 100 and home health services are covered with no copay and no coinsurance. Primary care visits, telehealth, and outpatient services also feature no copays, though some of these outpatient services may require up to a 20% coinsurance. For supplemental care, members benefit from preventive dental, routine vision, and select hearing aid coverage with no copay, though routine exams and medical equipment typically carry a 20% coinsurance. The plan also covers up to 36 one-way transportation trips per year to approved locations and over-the-counter items with no copay and no coinsurance. Emergency services are available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers inpatient acute and psychiatric hospital stays with a $1,400 copayment per Original Medicare benefit period and no coinsurance. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers outpatient services with no copays, though prior authorization and coinsurance may apply. Covered outpatient hospital, ambulatory surgical, and substance abuse services have no coinsurance to 20% coinsurance, while observation and outpatient blood services carry a 20% coinsurance.
Partial Hospitalization See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by the UHC Nursing Home Plan TX-F001 (PPO I-SNP), as transportation to any health-related location is not covered. Covered ground and air ambulance services require a 20% coinsurance and no copay, while up to 36 one-way trips per year to plan-approved locations are provided with no copay and no coinsurance.
Emergency Services See details
Emergency Services under the UHC Nursing Home Plan TX-F001 (PPO I-SNP) are covered with a $115 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services require a copay of $0 to $40 and no coinsurance. For worldwide emergency services, some services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) offers primary care benefits with no copays and coinsurance ranging from 0% to 20% for primary care, specialist, therapy, and mental health services. Telehealth and opioid treatment services are covered with no copays and no coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) offers partially covered preventive services, with annual physical exams, kidney disease education, and home safety modifications available with no copay and no coinsurance. Other covered services, including glaucoma screenings, digital rectal exams, and post-welcome visit EKGs, require a 20% coinsurance and no copay, while several supplemental benefits like fitness programs, health education, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered under the UHC Nursing Home Plan TX-F001 (PPO I-SNP), featuring no copay and a 20% coinsurance for annual routine hearing exams, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance, providing up to a $2,200 maximum benefit every two years, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) offers partially covered vision services, including one routine eye exam per year with no copay and 20% coinsurance. Covered eyewear, such as contact lenses, eyeglass lenses, and frames, features no copay and no coinsurance up to a $300 annual limit, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Nursing Home Plan TX-F001 (PPO I-SNP), offering Medicare-covered dental with no copay and a 20% coinsurance. Preventive services like oral exams, cleanings, fluoride, and x-rays are covered with no copay and no coinsurance, but other diagnostic, restorative, endodontic, periodontic, prosthodontic, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC Nursing Home Plan TX-F001 (PPO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and required prior authorization. You will pay a 20% coinsurance for most of these items, though coinsurance for prosthetic devices ranges from no coinsurance up to 20%.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan TX-F001 (PPO I-SNP) covers diagnostic and radiological services with prior authorization, including diagnostic radiological services with no copay and no coinsurance. Lab services feature no copay but require coinsurance, while diagnostic procedures require a copay and a minimum 20% coinsurance, and therapeutic radiology and X-rays require a minimum 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered by UHC Nursing Home Plan TX-F001 (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Nursing Home Plan TX-F001 (PPO I-SNP) with no copay and required prior authorization, though only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD 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 TX-F001 (PPO I-SNP) with no copay and no coinsurance for days 1 through 100, and does not require a prior three-day inpatient hospital stay. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Nursing Home Plan TX-F001 (PPO I-SNP), offering over-the-counter (OTC) items with no copay and no coinsurance. However, acupuncture, meal benefits, and other additional services under this category are not covered.
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