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UHC Nursing Home Plan OR-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 OR-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 OR-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan OR-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 Oregon. 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 OR-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 OR-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 OR-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 OR-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $55.00. 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 $6200.00 (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 $6200.00 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 OR-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. This plan's premium may be reduced if you qualify for the low-income subsidy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan OR-F001 (PPO I-SNP) offers a range of benefits with varying costs. Many services have no copay, including primary care, preventive services like annual exams, home health services, and dental services. Other services, such as inpatient hospital stays, have copays, while many outpatient services and specialized treatments have coinsurance costs. This plan covers a variety of services, including hearing, vision, and medical equipment, with specific costs depending on the service. Emergency services have a copay, and ambulance services have coinsurance. Overall, the plan provides a broad spectrum of benefits, but it's important to review the details for specific services to understand the associated costs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, each with a copay of $2000 for a Medicare-covered stay. Additional days, non-Medicare stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the UHC Nursing Home Plan OR-F001 (PPO I-SNP), including outpatient hospital services and observation services with a coinsurance between 0% and 10%, and Ambulatory Surgical Center (ASC) Services with a coinsurance between 0% and 10%. Outpatient Substance Abuse Services, including individual and group sessions, have a coinsurance between 0% and 20%, and Outpatient Blood Services have a coinsurance between 0% and 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, including ground and air ambulance services, each with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered with a $90 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $40 and no coinsurance. Worldwide Emergency Services, 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 have a 0% to 20% coinsurance. Occupational Therapy Services are covered with no coinsurance and no copay, and Physician Specialist Services have a 0% to 20% coinsurance. Individual and Group Sessions for Mental Health Specialty Services have a 0% to 20% coinsurance. Podiatry Services, Other Health Care Professional, and Psychiatric Services are covered with no copay and a 0% to 20% coinsurance, and the plan also covers Physical Therapy and Speech-Language Pathology Services with no copay. This plan also covers additional telehealth benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and additional preventive services including glaucoma screening with a 0-20% coinsurance, diabetes self-management training with no copay, barium enemas with no copay, digital rectal exams with a 0-20% coinsurance, and EKG following a welcome visit with a 0-20% coinsurance. Kidney Disease Education Services are covered with no copay. 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 are not covered. Home and bathroom safety devices and modifications are covered with no copay.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay and a coinsurance of at most 20%, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a maximum plan benefit of $3200, and OTC hearing aids have no copay.
Vision Services See details
The UHC Nursing Home Plan OR-F001 (PPO I-SNP) plan covers vision services, including eye exams with 0% to 20% coinsurance and routine eye exams with no copay. Eyewear is covered, including contact lenses, eyeglass lenses, and eyeglass frames with no copay for each, but eyeglasses (lenses and frames) and upgrades are not covered. The plan has a combined maximum benefit of $300 for eyewear.
Dental Services See details
The UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers dental services, including oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. The plan also covers restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery with no copay. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan OR-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, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a coinsurance between 0% and 20%, while Medical Supplies have a 20% coinsurance. Diabetic Supplies and Therapeutic Shoes/Inserts have a coinsurance between 20% and 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of up to 20%, while Lab Services and Outpatient X-Ray Services have no copay. Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan OR-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 specific services like Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is coinsurance for covered services, and prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan OR-F001 (PPO I-SNP) with prior authorization required. There is no copay for days 1-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, but 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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