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UHC Nursing Home Plan UT-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 UT-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 UT-F001 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan UT-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 Utah. 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 UT-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 UT-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 UT-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 UT-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.60. 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:
Sign up for UHC Nursing Home Plan UT-F001 (PPO I-SNP)
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Drug Coverage
The UHC Nursing Home Plan UT-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. You must pay this deductible amount out of pocket for your medications before your plan coverage begins to pay. This is an important upfront cost to consider when comparing Medicare drug plan options. Specific drug coverage tier details, including copayments and coinsurance rates, are currently unavailable for this plan. You can contact the plan provider directly to verify how your specific prescriptions are classified and what they will cost. This step ensures you have a clear understanding of your potential out-of-pocket expenses.
Additional Benefits
The UHC Nursing Home Plan UT-F001 (PPO I-SNP) offers comprehensive medical coverage featuring no copays for primary care, specialist visits, outpatient hospital services, and home health care, though coinsurance up to 20% may apply to certain outpatient and specialist services. For inpatient hospital stays, members pay a $1,380 copay per stay with no coinsurance, while emergency room visits require a $115 copay that is waived if admitted within 24 hours. Additionally, skilled nursing facility stays for days 1 through 100, ambulance services, and select diagnostic services like lab tests and X-rays are fully covered with no copays and no coinsurance. This plan also includes valuable supplemental benefits, such as dental, vision, and hearing coverage, all featuring no copays for routine exams and services. Dental care and eyewear are covered with no copays and no coinsurance up to annual limits of $2,400 and $300 respectively, while hearing aids are covered up to $2,200 every two years. Members also benefit from no copays or coinsurance on over-the-counter items, home safety devices, and home infusion services, making essential daily healthcare both accessible and affordable.
Inpatient Hospital See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) partially covers inpatient hospital services, requiring a $1,380 copay per Medicare-covered stay and no coinsurance for acute and psychiatric care, subject to prior authorization. Additional days, upgrades, and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
Outpatient Services covered by the UHC Nursing Home Plan UT-F001 (PPO I-SNP) feature no copays for all services, with coinsurance ranging from no coinsurance up to 20% depending on the care received. This comprehensive coverage applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, with prior authorization required for most services.
Partial Hospitalization See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Nursing Home Plan UT-F001 (PPO I-SNP) with no copay and no coinsurance. Ground and air ambulance services require prior authorization, while transportation benefits are partially covered for up to 36 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers emergency services 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
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers primary care, specialist, and mental health services with no copays and coinsurance ranging from no coinsurance up to 20%. Physical, occupational, speech, and telehealth therapies require no copays and no coinsurance, though chiropractic services are partially covered as routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by the UHC Nursing Home Plan UT-F001 (PPO I-SNP), featuring no copay and no coinsurance for annual physical exams and kidney disease education. Other services like glaucoma screenings, digital rectal exams, and post-welcome visit EKGs require a 20% coinsurance, while additional preventive benefits are only partially covered, offering home and bathroom safety devices with no copay but excluding fitness programs, health education, and personal emergency response systems.
Hearing Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) hearing services are partially covered, offering one annual routine hearing exam with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are also partially covered with no copay or coinsurance up to a $2,200 limit every two years, excluding inner ear, outer ear, and over-the-ear types. OTC hearing aids are covered with no copay and no coinsurance for up to two devices every two years.
Vision Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers vision services, featuring one routine eye exam per year with no copay and a 20% coinsurance, though other eye exam services are not covered. Covered eyewear options—including contact lenses, eyeglass lenses, and frames—have no copay and no coinsurance up to a $300 annual combined limit, while upgrades and combined eyeglasses packages are not covered.
Dental Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) partially covers dental services, as orthodontics is not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other preventive and comprehensive dental services have no copay and no coinsurance up to a $2,400 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the UHC Nursing Home Plan UT-F001 (PPO I-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy, have coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and prior authorization required. Members pay a 20% coinsurance for DME, medical supplies, and diabetic equipment, while prosthetic devices range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers diagnostic and radiological services with no copay and no coinsurance for lab services, diagnostic procedures, diagnostic radiology, and outpatient X-rays. Prior authorization is required for these services, and while therapeutic radiological services require no copay, they are subject to coinsurance.
Home Health Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) offers Cardiac Rehabilitation Services with no copay and a prior authorization requirement, though some services are not covered. Specifically, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, and does not require a prior three-day hospital stay. Prior authorization is required for this benefit, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Nursing Home Plan UT-F001 (PPO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other supplemental services are not covered under this plan.
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