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UHC Nursing Home Plan OK-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 OK-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 OK-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan OK-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 Oklahoma. 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 OK-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 OK-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 OK-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 OK-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.80. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 $4100.00 (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 $4100.00 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 OK-F001 (PPO I-SNP) has a defined standard drug benefit. The plan has a deductible of $590.00. If you qualify for the low-income subsidy (LIS), the plan's premium is $49.80. After you meet your deductible, you'll pay the costs for drugs in each tier until your total drug costs reach $2000.00. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan OK-F001 (PPO I-SNP) offers a range of benefits with varying cost-sharing. This plan covers inpatient hospital stays with a $1,000 copay, outpatient services with coinsurance, and emergency services with a $50 copay. This plan offers many services with no copay, including primary care, preventive services, hearing exams, vision exams, home health services, and many dental services. Additional benefits include coverage for hearing aids, eyewear, and a yearly maximum for dental services, making this a comprehensive plan for many healthcare needs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both with a $1,000 copay for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services (individual and group sessions), and outpatient blood services, are covered. Outpatient Hospital Services have a coinsurance between 0% and 20%, Observation Services have a 20% coinsurance, Ambulatory Surgical Center Services have a coinsurance between 0% and 20%, and outpatient substance abuse services (both individual and group sessions) have a coinsurance between 0% and 20%. Outpatient Blood Services have a coinsurance between 0% and 20%.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Nursing Home Plan OK-F001 (PPO I-SNP) with no copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Nursing Home Plan OK-F001 (PPO I-SNP). Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location are covered with no copay.
Emergency Services See details
Emergency Services are covered, with a $50 copay and no coinsurance. Urgently Needed Services are covered, with a copay between $0 and $40 and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The UHC Nursing Home Plan OK-F001 (PPO I-SNP) covers primary care physician services with no copay, chiropractic services with a 0% to 20% coinsurance, occupational therapy services with no coinsurance and no copay, and physician specialist services with a 0% to 20% coinsurance. This plan also covers mental health specialty services with a 0% to 20% coinsurance, podiatry services with a 0% to 20% coinsurance, and other health care professional services with no copay. Additional benefits include psychiatric services with a 0% to 20% coinsurance, physical therapy and speech-language pathology services with no copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other services like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Glaucoma screenings, digital rectal exams, and EKGs following a welcome visit have a coinsurance between 0% and 20%, while diabetes self-management training and barium enemas have no copay.
Hearing Services See details
Hearing Services include coverage for hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay and at most 20% coinsurance, while prescription hearing aids (all types) have no copay for 2 visits per year with a maximum benefit of $2,200 per year, and OTC hearing aids have no copay for 2 hearing aids every year.
Vision Services See details
The UHC Nursing Home Plan OK-F001 (PPO I-SNP) covers vision services, including routine eye exams with no copay and coinsurance between 0% and 20%, and eyewear including contact lenses, eyeglass lenses, and frames with no copay, up to a combined maximum of $250 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 0% - 20% coinsurance, other dental services, and various services such as oral exams, x-rays, cleanings, and fluoride treatments with no copay. This plan also offers a maximum of $3250 per year for dental services, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan OK-F001 (PPO I-SNP). The coinsurance for dialysis services ranges from 0% to 20%, and prior authorization is required.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with 20% coinsurance for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts; however, Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a coinsurance between 0-20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with different cost-sharing depending on the service. Diagnostic Procedures/Tests have a coinsurance of up to 20%, and Lab Services have no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of up to 20% (with a minimum of 0% and 20% respectively), while Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan OK-F001 (PPO I-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization, and the plan has no copay for days 1-100. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items, which are covered with no copay, while acupuncture, meal benefits, 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.
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