Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Nursing Home Plan MN-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 MN-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan MN-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 Minnesota. 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 MN-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 MN-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.
Below are a few key facts and commonly-asked questions about UHC Nursing Home Plan MN-F001 (PPO I-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For UHC Nursing Home Plan MN-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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.
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The UHC Nursing Home Plan MN-F001 (PPO I-SNP) has a $590 deductible for prescription drugs. After the deductible, the plan covers drugs, but the specific cost-sharing amounts for each tier are not available in this summary. Once your total drug costs reach $2000, you enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
The UHC Nursing Home Plan MN-F001 (PPO I-SNP) offers a range of benefits, including coverage for inpatient and outpatient services, and a variety of specialist services. You'll have no copay for services like primary care, preventive services, and home health, with a $2,000 copay for inpatient hospital stays, and a $110 copay for emergency services. The plan includes vision and dental benefits, with no copay for routine eye exams and oral exams, and a yearly maximum of $3,250 for dental services. You can also expect coverage for hearing services, medical equipment, and home infusion, with varying copays and coinsurance amounts for specific services.
Inpatient Hospital benefits are covered, with a copay of $2,000 for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services include coverage for Outpatient Hospital Services with a coinsurance of 0% to 20%, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a coinsurance between 0% and 20%, Outpatient Substance Abuse Services with a coinsurance between 0% and 20%, and Outpatient Blood Services with a coinsurance of 0% to 20%. Prior authorization is required for these services.
Partial Hospitalization is covered with no copay. Prior authorization is required.
Ambulance and Transportation Services includes coverage for all ambulance services with 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 36 one-way trips per year, but Transportation Services to any health-related location is not covered.
Emergency Services are covered under the UHC Nursing Home Plan MN-F001 (PPO I-SNP), with a $110 copay and no coinsurance. Urgently Needed Services are covered with a copay between $0 and $40, and no coinsurance, while Worldwide Emergency Services are not covered.
The UHC Nursing Home Plan MN-F001 (PPO I-SNP) plan covers primary care physician services with no copay. Chiropractic services are covered with a 0-20% coinsurance, and occupational therapy services are covered with no coinsurance and no copay. Physician specialist services and mental health specialty services are covered with a 0-20% coinsurance, and podiatry services are covered with a 0-20% coinsurance and no copay. Other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services are covered with no copay.
The UHC Nursing Home Plan MN-F001 (PPO I-SNP) covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, but the copay is listed elsewhere in the plan details, and some services such as health education, in-home safety assessments, and others are not covered.
Hearing Services include hearing exams and prescription hearing aids, with routine hearing exams covered at no copay and no coinsurance, and prescription hearing aids covered with a maximum benefit of $2500 per year. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered, while OTC hearing aids are covered with no copay.
The UHC Nursing Home Plan MN-F001 (PPO I-SNP) plan covers vision services, including routine eye exams with no copay and a coinsurance between 0% and 20%, and eyewear with a combined maximum plan benefit coverage of $300 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
The UHC Nursing Home Plan MN-F001 (PPO I-SNP) plan covers dental services with a yearly maximum of $3,250, and includes no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery. Orthodontics is not covered.
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services are covered by the UHC Nursing Home Plan MN-F001 (PPO I-SNP) and require prior authorization. You will pay between 0% and 20% coinsurance for these services.
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Equipment with a 20% coinsurance for both Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Lab Services and Outpatient X-Ray Services have no copay, while Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services are covered by the UHC Nursing Home Plan MN-F001 (PPO I-SNP) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services are covered, but not covered in practice because none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan MN-F001 (PPO I-SNP), with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services provides coverage for Over-the-Counter (OTC) Items with no copay. Acupuncture, Meal Benefit, 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.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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