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UHC Care Advantage OR-E001 (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Care Advantage OR-E001 (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 Care Advantage OR-E001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Care Advantage OR-E001 (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 Care Advantage OR-E001 (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 Care Advantage OR-E001 (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 Care Advantage OR-E001 (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 Care Advantage OR-E001 (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 $270.00 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 $6300.00 (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 $6300.00 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 Care Advantage OR-E001 (PPO I-SNP) Medicare plan features an annual prescription drug deductible of $270. Tier 1 preferred generic drugs are highly accessible with no copay for standard pharmacy fills and mail-order services. Tier 2 generic drugs are also affordable, requiring a $12 copay for a 1-month standard pharmacy supply, or no copay for a 3-month supply through preferred mail order. For higher-tier medications, cost-sharing transitions to coinsurance. Tier 3 preferred brand drugs require a 25% coinsurance for both standard pharmacy and mail-order fills. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 50% and 30% coinsurance respectively for a 1-month supply.
Additional Benefits
The UHC Care Advantage OR-E001 (PPO I-SNP) offers comprehensive medical coverage featuring no copay and no coinsurance for primary care, telehealth, and home health services. For hospital care, inpatient stays require a $350 daily copay for the first seven days and no copay for days 8 through 90, while emergency room visits carry a $150 copay. Specialist doctor visits require a copay of up to $35, and skilled nursing facility care is covered with no copay or coinsurance for up to 100 days. This plan also provides strong supplemental benefits, including dental coverage up to a $2,000 annual maximum and routine vision exams with a $300 annual eyewear allowance, both with no copays or coinsurance. Covered hearing aids are also available with no copay up to a $2,500 maximum benefit every two years. For other services like dialysis, durable medical equipment, and diagnostic procedures, members will generally pay a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers inpatient hospital services with no coinsurance, requiring a $350 daily copay for days 1 through 7 and no copay for days 8 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers outpatient services with no coinsurance, though prior authorization is required. There is no copay for ambulatory surgical center and blood services, while outpatient hospital services require a copay of $0 to $350 (including $350 per day for observation services) and substance abuse services have copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Care Advantage OR-E001 (PPO I-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers ground and air ambulance services with a $205.00 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by UHC Care Advantage OR-E001 (PPO I-SNP) with a $150 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Care Advantage OR-E001 (PPO I-SNP) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $35 copay and no coinsurance. Physical, occupational, and speech therapies carry a $35 copay with no coinsurance, and although some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Care Advantage OR-E001 (PPO I-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and home safety devices. Numerous supplemental benefits are not covered, including fitness benefits, health education, in-home safety assessments, nutritional therapy, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by UHC Care Advantage OR-E001 (PPO I-SNP) with no copay and no coinsurance for covered benefits, though prior authorization is required for exams and prescription aids. Routine exams and OTC hearing aids are covered, but fitting/evaluation services and inner, outer, or over-the-ear prescription hearing aids are not covered. Covered prescription aids offer a $2,500 maximum benefit every two years for up to two devices.
Vision Services See details
Vision services are partially covered by UHC Care Advantage OR-E001 (PPO I-SNP) with no copay, no coinsurance, and no deductible. The plan covers one routine eye exam per year and provides up to $300 annually for contact lenses, eyeglass lenses, and eyeglass frames, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers most dental services with no copay and no coinsurance up to a $2,000 annual maximum, though orthodontics are not covered. Medicare-covered dental services are covered with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers Home Infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry no copay and ranging from no coinsurance to 20% coinsurance, while insulin requires a $35 copay and ranging from no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers durable medical equipment (DME) and medical supplies with no copay and 20% coinsurance. Prosthetic devices are covered with no copay and coinsurance ranging from no coinsurance to 20%, while diabetic supplies have no copay and therapeutic shoes or inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Care Advantage OR-E001 (PPO I-SNP) with prior authorization. Diagnostic procedures and therapeutic radiology require 20% coinsurance, diagnostic radiological services require a copay with no coinsurance, and lab services and outpatient X-rays have no copay but are subject to coinsurance.
Home Health Services See details
Home health services are covered by UHC Care Advantage OR-E001 (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Care Advantage OR-E001 (PPO I-SNP) covers Cardiac Rehabilitation Services with no copay and no coinsurance, but in practice only some services are covered as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Care Advantage OR-E001 (PPO I-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 100, requiring prior authorization but no prior three-day hospital stay. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Care Advantage OR-E001 (PPO I-SNP), which offers over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated dual-eligible services are not covered under this plan.
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