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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 2026, 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 2026.
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 $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 OR-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. This means you will need to pay this amount out-of-pocket for your covered medications before the plan begins to pay its share. Specific details regarding drug coverage tiers, copays, and coinsurance are currently unavailable for this plan. To understand your exact out-of-pocket costs, you should verify your personal medication list directly with the plan provider.
Additional Benefits
The UHC Nursing Home Plan OR-F001 (PPO I-SNP) offers robust medical coverage with many essential services featuring no copays. For major medical needs, inpatient hospital stays require a $2,000 copay per stay with no coinsurance, while skilled nursing facility stays up to 100 days and home health services are covered with no copay or coinsurance. Outpatient services, primary care, and routine diagnostic tests also feature no copay, though some services may carry a coinsurance of up to 20%. This plan also includes valuable supplemental benefits designed to lower your out-of-pocket health expenses. Dental services are covered with no copay or coinsurance up to a $2,400 annual limit, and eyewear is covered with no copay or coinsurance up to a $300 annual maximum. Additionally, members benefit from no copay or coinsurance for prescription hearing aids up to $2,200 every two years, over-the-counter items, and up to 24 one-way health-related transportation trips per year.
Inpatient Hospital See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) partially covers inpatient hospital services, with covered acute and psychiatric stays requiring a $2,000 copayment per stay and no coinsurance. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan OR-F001 (PPO I-SNP) with no copay, though prior authorization is required. These covered benefits—including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services—feature no copay and coinsurance ranging from no coinsurance up to 20%.
Partial Hospitalization See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved health-related locations via taxi or medical transport with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services under the UHC Nursing Home Plan OR-F001 (PPO I-SNP) are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from no copay to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Primary Care is covered by the UHC Nursing Home Plan OR-F001 (PPO I-SNP) with no copay and 0% to 20% coinsurance for primary care, specialist, and mental health visits. Therapy services require no copay and 20% coinsurance, and although some chiropractic services are covered, routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by the UHC Nursing Home Plan OR-F001 (PPO I-SNP) with no copay or coinsurance for annual physical exams, kidney disease education, and home safety devices. Glaucoma screenings, digital rectal exams, and post-welcome visit EKGs require a 20% coinsurance, while additional preventive sub-services like fitness, health education, in-home support, and personal emergency response systems are not covered.
Hearing Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) provides partially covered hearing services, including one routine hearing exam per year with a 20% coinsurance and no copay. Prescription hearing aids (up to $2,200 every two years) and OTC hearing aids are covered with no copay and no coinsurance, though hearing aid fittings and evaluations, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by the UHC Nursing Home Plan OR-F001 (PPO I-SNP), featuring one routine eye exam per year with no copay, a 20% coinsurance, and no deductible. Covered eyewear, including contact lenses, eyeglass lenses, and frames, has no copay, no coinsurance, and no deductible up to a $300 annual maximum, while upgrades, other eye exams, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by UHC Nursing Home Plan OR-F001 (PPO I-SNP), with orthodontics not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,400 annual maximum.
Home Infusion bundled Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers Home Infusion bundled Services with no copay, although prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers medical equipment, including durable medical equipment, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prosthetic devices are also covered with no copay and a coinsurance ranging from no coinsurance up to 20%.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic procedures and tests require a copay and 20% coinsurance, lab services have no copay, diagnostic radiological services have no copay or coinsurance, and therapeutic radiology and outpatient X-rays require 20% coinsurance with no copay.
Home Health Services See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are partially covered under the UHC Nursing Home Plan OR-F001 (PPO I-SNP) with no copay and prior authorization required. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan OR-F001 (PPO I-SNP) provides partially covered Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. Additional days beyond the Medicare-covered limit are not covered, but the plan does allow admission without requiring a prior three-day inpatient hospital stay.
Other Services See details
Other Services are partially covered by UHC Nursing Home Plan OR-F001 (PPO I-SNP), which offers Over-the-Counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and certain CMS OTC list drugs are not covered under this benefit.
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