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UHC Nursing Home Plan IL-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 IL-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 IL-F001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan IL-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 Illinois. 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 IL-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 IL-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 IL-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 IL-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.20. 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 $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 IL-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before your coverage fully kicks in. Understanding this initial cost is a key factor when calculating your overall healthcare budget. Specific drug tier details, including copayments and coinsurance amounts for individual medications, are not available for this plan. To determine how your specific prescriptions are covered, you should consult the plan's formulary or contact a representative. This will help you estimate your ongoing monthly medication costs before making an enrollment decision.
Additional Benefits
The UHC Nursing Home Plan IL-F001 (PPO I-SNP) offers comprehensive coverage with many key services featuring no copays. Inpatient hospital stays require a $1,720 copay per benefit period with no coinsurance, while skilled nursing facility stays and home health services are covered with no copays or coinsurance. Primary care, specialist visits, and outpatient services also feature no copays, though coinsurance ranging from 0% to 20% may apply depending on the service. For additional healthcare needs, the plan provides routine dental, vision, and hearing exams with no copays, alongside allowances of up to $300 annually for eyewear and $2,200 every two years for hearing aids. Beneficiaries can also access up to 24 one-way transportation trips per year to plan-approved locations and over-the-counter items with no copay or coinsurance. Standard medical equipment, dialysis, and diagnostic services generally require no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP) with a $1,720 copay per benefit period and no coinsurance for both acute and psychiatric stays. Prior authorization is required, and this benefit is only partially covered as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP) with no copays, with coinsurance ranging from no coinsurance to 20% depending on the service. Prior authorization is required for these services, which include outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services.
Partial Hospitalization See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
UHC Nursing Home Plan IL-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 locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay to a $40 copay and no coinsurance. For worldwide emergency services, some services are covered but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers primary care, specialist, mental health, psychiatric, and podiatry services with no copay and 0% to 20% coinsurance. Physical, occupational, and speech therapies require no copay and 20% coinsurance, while telehealth and opioid treatments feature no copay and no coinsurance. Some chiropractic services are covered, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP), offering annual physical exams, kidney disease education, and home safety modifications with no copay and no coinsurance. Glaucoma screenings and EKGs require no copay and a 20% coinsurance, digital rectal exams require a copay and a 20% coinsurance, while supplemental benefits like fitness programs, health education, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP) include one routine hearing exam per year with no copay, a 20% coinsurance, and no deductible, as well as OTC and prescription hearing aids with no copay and no coinsurance up to a $2,200 maximum limit every two years. However, this benefit is only partially covered, as fitting and evaluation exams, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision Services are partially covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP), which offers one routine eye exam annually with no copay and a 20% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $300 annual limit for contact lenses, eyeglass lenses, and frames, while upgrades and packaged eyeglasses (lenses and frames) are not covered. No deductibles apply to these vision benefits.
Dental Services See details
Dental services under the UHC Nursing Home Plan IL-F001 (PPO I-SNP) are partially covered, offering Medicare-covered dental services with no copay and 20% coinsurance, and preventive services like exams and cleanings with no copay and no coinsurance. However, other diagnostic services and comprehensive treatments—including restorative, endodontics, periodontics, prosthodontics, oral surgery, and orthodontics—are not covered.
Home Infusion bundled Services See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including insulin and chemotherapy, feature no copay to a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the UHC Nursing Home Plan IL-F001 (PPO I-SNP) with no copay and a 20% coinsurance, requiring prior authorization.
Medical Equipment See details
Medical equipment is covered under the UHC Nursing Home Plan IL-F001 (PPO I-SNP) with no copays, though prior authorization is required for all services. Covered items, including durable medical equipment (DME), medical supplies, and diabetic equipment, require a 20% coinsurance, while prosthetic devices carry a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers diagnostic and radiological services with prior authorization, featuring no copay and no coinsurance for diagnostic radiological services. Lab services, therapeutic radiology, and outpatient X-rays have no copays but require coinsurance (minimum 20% for radiology and X-rays), while diagnostic procedures require both a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Nursing Home Plan IL-F001 (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers Cardiac Rehabilitation Services with no copay, though only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered, and these services require prior authorization and a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 100, and does not require a prior three-day hospital stay. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Nursing Home Plan IL-F001 (PPO I-SNP) partially covers Other Services, as acupuncture and meal benefits are not covered. Over-the-counter (OTC) items are covered under this benefit with no copay and no coinsurance.
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