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UHC Nursing Home Plan GA-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 GA-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 GA-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan GA-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 Georgia. 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 GA-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 GA-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 GA-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 GA-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.70. 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 $9300.00 (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 $9300.00 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 GA-F001 (PPO I-SNP) has a $590 deductible for prescription drugs. After the deductible is met, the plan covers the cost of your prescriptions, but the specific costs for each tier are not listed. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your Part D premium may be reduced.
Additional Benefits
The UHC Nursing Home Plan GA-F001 (PPO I-SNP) offers a range of benefits, including inpatient hospital stays with a $2,000 copay. Outpatient services and ambulance services have coinsurance, while emergency services have a copay. Primary care and preventive services have no copay, with some services having coinsurance. This plan also covers hearing, vision, and dental services, with no copays for routine exams and a combined maximum benefit for eyewear. Additionally, the plan provides coverage for home infusion, dialysis, and medical equipment with varying coinsurance amounts. Skilled nursing facility services have no copay for the first 100 days.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both with a $2,000 copay for a Medicare-covered stay. Additional Days for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered with a coinsurance between 0% and 20%. Observation services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with no copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services, including ground and air ambulance, are covered with a 20% coinsurance. Transportation services to plan-approved health-related locations are covered, offering 24 one-way trips per year via taxi or medical transport, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered under the UHC Nursing Home Plan GA-F001 (PPO I-SNP), with a $110 copay for Emergency Services and a copay between $0 and $40 for Urgently Needed Services, and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The UHC Nursing Home Plan GA-F001 (PPO I-SNP) covers primary care physician services with no copay, and covers chiropractic services with a 0% to 20% coinsurance. Occupational therapy services, physical therapy, and speech-language pathology services are covered with no coinsurance and no copay, while physician specialist services and mental health specialty services are covered with 0% to 20% coinsurance. Podiatry services are covered with a 0% to 20% coinsurance and no copay, other health care professional services have no copay, and psychiatric services are covered with a 0% to 20% coinsurance. Additional telehealth benefits and opioid treatment program services are covered with no copay.
Preventive Services See details
The UHC Nursing Home Plan GA-F001 (PPO I-SNP) covers preventive services, including an annual physical exam with no copay. Additional preventive services include coverage for home and bathroom safety devices and modifications with no copay. The plan also covers kidney disease education services with no copay. Other preventive services include 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. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, and counseling services.
Hearing Services See details
Hearing services include hearing exams and prescription and OTC hearing aids. Routine hearing exams have no copay, no coinsurance, and are covered once per year, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a $3,200 annual benefit for both in and out-of-network services, and OTC hearing aids have no copay and are limited to 2 per year.
Vision Services See details
Vision Services are covered, including eye exams and eyewear. Routine eye exams have no copay and a 0-20% coinsurance, while eyewear has a $300 combined maximum benefit per year, with no copay for contact lenses, eyeglass lenses, and eyeglass frames.
Dental Services See details
Dental services include coverage for Medicare dental services with a coinsurance of 0% to 20%, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery, all with no copay. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UHC Nursing Home Plan GA-F001 (PPO I-SNP), 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 for this benefit.
Dialysis Services See details
Dialysis Services are covered by the UHC Nursing Home Plan GA-F001 (PPO I-SNP), but require prior authorization. There is no minimum coinsurance, but the maximum coinsurance is 20%.
Medical Equipment See details
Medical equipment is covered under the UHC Nursing Home Plan GA-F001 (PPO I-SNP), with a 20% coinsurance for Durable Medical Equipment (DME), Medicare-covered Prosthetic Devices, and Medicare-covered Medical Supplies. Durable Medical Equipment for use outside the home is not covered, while Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered with a coinsurance of at most 20%, while lab services have no copay. Therapeutic Radiological Services have a coinsurance of at most 20% and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan GA-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, but not in practice. Prior authorization is required, and there is a coinsurance for some services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan GA-F001 (PPO I-SNP). For days 1-100, there is no copay.
Other Services See details
Other Services includes 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.
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