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UHC Nursing Home Plan OH-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 OH-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 OH-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan OH-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 Ohio. 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 OH-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 OH-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 OH-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 OH-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.30. 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 $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 $8600.00 (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 $8600.00 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 OH-F001 (PPO I-SNP) has a $590.00 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs, but the specific cost sharing amounts for each drug tier are not available in the provided information. Once your total drug costs reach $2,000.00, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you will pay $39.30.
Additional Benefits
The UHC Nursing Home Plan OH-F001 (PPO I-SNP) offers a range of benefits, including no copay for primary care, routine eye exams, home health services, and skilled nursing facility stays up to 100 days. The plan also covers dental services with a $3,250 annual maximum benefit and offers coverage for hearing services, including routine hearing exams and hearing aids. This plan includes coverage for inpatient hospital stays with a $2,000 copay, emergency services with a $110 copay, and ambulance services with 20% coinsurance. Additional benefits cover outpatient services, preventive services, and medical equipment, with some services subject to coinsurance between 0% and 20%.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a copay of $2,000 for a Medicare-covered stay. Additional days for Inpatient Hospital-Acute and Psychiatric, as well as non-Medicare covered stays and upgrades, are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, and ambulatory surgical center services have no copay. Outpatient substance abuse services have a coinsurance between 0% and 20% for individual and group sessions. Outpatient blood services have a coinsurance between 0% and 20%.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Nursing Home Plan OH-F001 (PPO I-SNP) with no copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, up to 60 one-way trips per year; transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the UHC Nursing Home Plan OH-F001 (PPO I-SNP) with a $110 copay, and no coinsurance. Urgently Needed Services have 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
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a 0% - 20% coinsurance. Occupational Therapy Services are covered with no coinsurance and no copay. Physician Specialist Services are covered with a 0% - 20% coinsurance. Mental Health Specialty Services are covered with a 0% - 20% coinsurance. Podiatry Services are covered with a 0% - 20% coinsurance and no copay. Other Health Care Professional services are covered with no copay. Psychiatric Services are covered with a 0% - 20% coinsurance. Physical Therapy and Speech-Language Pathology Services are covered with no copay. Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
The UHC Nursing Home Plan OH-F001 (PPO I-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are also covered, including glaucoma screening with 0-20% coinsurance, diabetes self-management training, and barium enemas with no copay, digital rectal exams and EKG following Welcome Visit with 0-20% coinsurance.
Hearing Services See details
Hearing services include routine hearing exams with no copay and a coinsurance of at most 20%, and OTC hearing aids with no copay. Prescription hearing aids are covered with a maximum benefit of $2500 every year with no copay, but fitting/evaluation for hearing aids, and prescription hearing aids for inner and outer ears are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and contact lenses. Routine eye exams have no copay, but a coinsurance of 0-20% may apply. Eyewear benefits, including contact lenses, eyeglass lenses, and eyeglass frames, are covered with no copay, and a combined maximum of $250 per year for both in and out-of-network services. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services offers a $3,250 annual maximum benefit, with Medicare Dental Services subject to prior authorization and 0-20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. There is no copay, and the coinsurance ranges from 0% to 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with 20% coinsurance for diabetic supplies and therapeutic shoes/inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a coinsurance of up to 20%, and Lab Services with no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of up to 20%, while Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan OH-F001 (PPO I-SNP) with no copay and no coinsurance, though Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Nursing Home Plan OH-F001 (PPO I-SNP). This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan OH-F001 (PPO I-SNP) with prior authorization. For days 1-100, there is no copay.
Other Services See details
Other Services include coverage for 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. The plan also offers nicotine replacement therapy (NRT) and naloxone coverage as a Part C OTC benefit.
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