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UHC Nursing Home Plan RI-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 RI-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 RI-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan RI-F001 (PPO I-SNP) is a PPO I-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Rhode Island. 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 RI-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 RI-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 RI-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 RI-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $52.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.30. 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 $7800.00 (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 $7800.00 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 RI-F001 (PPO I-SNP) has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the next coverage phase. If you qualify for the low-income subsidy, your monthly premium for Part D will be $52.50.
Additional Benefits
The UHC Nursing Home Plan RI-F001 (PPO I-SNP) offers a range of benefits. Inpatient hospital stays have a $2,000 copay, while outpatient services, including primary care and preventive services like annual physical exams, usually have no copay. This plan covers various services like ambulance, hearing, vision, dental, and home health services, often with no copay or a coinsurance between 0% and 20%. Additionally, services such as skilled nursing facilities (days 1-100), and over-the-counter items are covered with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the UHC Nursing Home Plan RI-F001 (PPO I-SNP), but require prior authorization. Both acute and psychiatric inpatient hospital stays have a $2,000 copay for a Medicare-covered stay, while additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a coinsurance of 0% - 20%, while observation services have a 20% coinsurance. Ambulatory surgical center (ASC) services, individual and group sessions for outpatient substance abuse have a coinsurance between 0% - 20%, and outpatient blood services have a coinsurance of 0% - 20%.
Partial Hospitalization See details
Partial Hospitalization is covered with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Nursing Home Plan RI-F001 (PPO I-SNP), with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services are covered under the UHC Nursing Home Plan RI-F001 (PPO I-SNP) with a $100 copay, and Urgently Needed Services are covered with a copay between $0 and $40. 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, while Chiropractic Services are covered with a 0-20% coinsurance and require prior authorization. Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are also covered, but may require prior authorization. Podiatry Services are covered with 0-20% coinsurance and no copay for Medicare-covered services, and Other Health Care Professional services are covered with no copay.
Preventive Services See details
The UHC Nursing Home Plan RI-F001 (PPO I-SNP) covers preventive services, including an annual physical exam with no copay. Other preventive services are partially covered, with no copay for Barium Enemas, and a 0-20% coinsurance for Glaucoma Screening, EKG following Welcome Visit, and Digital Rectal Exams.
Hearing Services See details
Hearing services include routine hearing exams with no copay and at most 20% coinsurance, prescription hearing aids with a $2,500 annual benefit, and OTC hearing aids with no copay. Fitting/evaluation for hearing aids, and prescription hearing aids (inner ear, outer ear, and over the ear) are not covered.
Vision Services See details
Under the UHC Nursing Home Plan RI-F001 (PPO I-SNP), eye exams are covered with a coinsurance of 0-20% for routine eye exams, and eyewear benefits are covered with a combined maximum of $300 per year, covering contact lenses, eyeglass lenses, and eyeglass frames with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are covered with no copay. Orthodontics is not covered.
Home Infusion bundled Services See details
The UHC Nursing Home Plan RI-F001 (PPO I-SNP) covers Home Infusion bundled Services, including Medicare Part B Insulin Drugs with a $35 copay and between 0% and 20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. There is a coinsurance between 0% and 20% for this benefit.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), is covered by the UHC Nursing Home Plan RI-F001 (PPO I-SNP) with a 20% coinsurance and no copay; however, Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices are covered with a 0-20% coinsurance and no copay, while Medical Supplies have a 20% coinsurance and no copay. Diabetic Equipment is covered with a 20% coinsurance and no copay for both Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Outpatient X-Ray Services have no copay, and Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan RI-F001 (PPO I-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan RI-F001 (PPO I-SNP) with prior authorization. For days 1-100, there is no copay.
Other Services See details
The UHC Nursing Home Plan RI-F001 (PPO I-SNP) plan covers Over-the-Counter (OTC) Items with no copay. However, 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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