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UHC Nursing Home Plan WA-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 WA-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 WA-F001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan WA-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 Washington. 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 WA-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 WA-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 WA-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 WA-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $10.50. 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 WA-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. This deductible must be met before the plan begins to pay its share for your covered medications. Specific drug tier details, including individual copayments and coinsurance amounts, are currently unavailable for this plan. Understanding your prescription drug costs is essential when choosing the right Medicare Advantage plan. Since tier-specific copays are not detailed, you should verify coverage for your specific prescriptions directly with the provider to determine your expected out-of-pocket expenses.
Additional Benefits
The UHC Nursing Home Plan WA-F001 (PPO I-SNP) offers robust healthcare coverage featuring no copay for outpatient care, primary doctor visits, and home health services, though some specialist services may carry up to a twenty percent coinsurance. Inpatient hospital stays require a two thousand dollar copay per stay with no coinsurance, while emergency room visits incur a one hundred fifteen dollar copay. Additionally, skilled nursing facility stays for the first one hundred days and up to sixty approved one-way transportation trips per year are covered with no copay and no coinsurance. For ancillary care, the plan features preventive and comprehensive dental benefits up to a two thousand dollar annual limit and prescription hearing aids up to twenty-two hundred dollars every two years, both with no copay or coinsurance. Routine vision and hearing exams are covered with no copay and a twenty percent coinsurance, plus members receive a three hundred dollar annual eyewear allowance with no copay or coinsurance. Select over-the-counter items and home safety modifications are also available with no copay and no coinsurance.
Inpatient Hospital See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) partially covers inpatient hospital services, requiring a $2000 copayment per Medicare-covered stay and no coinsurance for acute and psychiatric care. Prior authorization is required, and non-covered sub-services include additional hospital days, non-Medicare-covered stays, and upgrades for acute stays.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan WA-F001 (PPO I-SNP) with no copay, though coinsurance ranging from no coinsurance up to 20% applies depending on the service. Prior authorization is required for outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with the deductible waived for the first three pints of blood.
Partial Hospitalization See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the UHC Nursing Home Plan WA-F001 (PPO I-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Plan-approved transportation services offer up to 60 one-way trips per year with no copay or coinsurance, though transportation to any non-approved health-related location is not covered.
Emergency Services See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay to a $40 copay and no coinsurance. While some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers primary care, specialist, and mental health services with no copay and 0% to 20% coinsurance, while physical, occupational, and speech therapies have no copay and a 20% coinsurance. Chiropractic services are not covered, but telehealth and opioid treatment program services are available with no copay and no coinsurance.
Preventive Services See details
Preventive Services are partially covered by the UHC Nursing Home Plan WA-F001 (PPO I-SNP), offering annual physicals, kidney disease education, diabetes self-management, and home safety modifications with no copay and no coinsurance, while glaucoma screenings, digital rectal exams, and EKGs require a 20% coinsurance and no copay. Sub-services not covered include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, fitness, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by the UHC Nursing Home Plan WA-F001 (PPO I-SNP), featuring one routine hearing exam annually with no copay and 20% coinsurance, and up to two OTC hearing aids every two years with no copay or coinsurance. Prescription hearing aids are covered up to $2,200 every two years with no copay or coinsurance, but fitting and evaluation services, as well as inner ear, outer ear, and over the ear prescription models, are not covered.
Vision Services See details
Vision Services are partially covered by the UHC Nursing Home Plan WA-F001 (PPO I-SNP), which includes one routine eye exam per year with no copay and a 20% coinsurance, while other eye exams are excluded. Covered eyewear—such as contact lenses, eyeglass lenses, and frames—features no copay, no coinsurance, and no deductible up to a $300 annual limit, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Nursing Home Plan WA-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, though orthodontic services are not covered. Medicare-covered dental services are covered with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan WA-F001 (PPO I-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers durable medical equipment, prosthetic devices, medical supplies, and diabetic equipment with no copay. A 20% coinsurance applies to most items, though prosthetic devices range from no coinsurance up to 20% coinsurance, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the UHC Nursing Home Plan WA-F001 (PPO I-SNP) with prior authorization required. Lab services have no copay, diagnostic procedures and tests require a copay and 20% coinsurance, and radiological services feature no copays, carrying a 20% coinsurance for therapeutic and X-ray services and no coinsurance for diagnostic radiology.
Home Health Services See details
Home Health Services are covered under the UHC Nursing Home Plan WA-F001 (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) provides cardiac rehabilitation where some services are covered with no copay and a 20% coinsurance, subject to prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Nursing Home Plan WA-F001 (PPO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, including nicotine replacement therapy and naloxone. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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