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UHC Nursing Home Plan SC-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 SC-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 SC-F001 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan SC-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 South Carolina. 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 SC-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 SC-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 SC-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 SC-F001 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $46.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.80. 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 $8300.00 (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 $8300.00 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 SC-F001 (PPO I-SNP) has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs. 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 Medicare Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) offers a range of benefits with varying costs. Inpatient hospital stays have a $2,000 copay, while outpatient services, including emergency services, may have a coinsurance up to 20%. Many services, such as primary care, preventive services, and dental services, have no copay. Additional benefits include coverage for hearing, vision, and home health services, with some services like prescription hearing aids covered up to a maximum annual amount. The plan also covers medical equipment, diagnostic services, and skilled nursing facility services, with some services requiring prior authorization. However, the plan does not cover certain services like cardiac rehabilitation, additional hours of care, or worldwide emergency services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered with a copay of $2,000 for a Medicare-covered stay. Additional days and non-Medicare-covered stays for both acute and psychiatric hospitalizations are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a coinsurance of 0% - 20%, Observation Services have a 20% coinsurance, Ambulatory Surgical Center Services, Individual Sessions for Outpatient Substance Abuse, and Group Sessions for Outpatient Substance Abuse have a coinsurance between 0% - 20%, and Outpatient Blood Services have a coinsurance between 0% - 20%.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Nursing Home Plan SC-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, including ground and air ambulance services, with a 20% coinsurance. Transportation services to a plan-approved health-related location are covered with no copay.
Emergency Services See details
Emergency Services and Urgently Needed Services are covered under the UHC Nursing Home Plan SC-F001 (PPO I-SNP), with a $110 copay for Emergency Services and a copay of $0-$40 for Urgently Needed Services, and no coinsurance for either. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) covers Primary Care Physician Services with no copay, Chiropractic Services with a 0-20% coinsurance, and Occupational Therapy Services with no coinsurance and no copay. The plan also covers Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Some services require prior authorization.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services. Additional preventive services may have a copay, and some services, such as Glaucoma Screening and EKG following Welcome Visit, have a coinsurance of up to 20%.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams are covered with no copay and no coinsurance, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, up to a maximum of $3200 per year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services include coverage for eye exams and eyewear. Routine eye exams have no copay and a 0% to 20% coinsurance, and you are allowed one exam every year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, and an annual combined maximum of $300 for both in-network and out-of-network services; however, eyeglass frames and lenses are limited to one per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) plan covers dental services, including oral exams, dental x-rays, and cleanings with no copay, and other diagnostic and preventive services with no copay. Medicare Dental Services have a coinsurance between 0% and 20%, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. The coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan SC-F001 (PPO I-SNP), but require prior authorization. There is no minimum coinsurance, but the maximum coinsurance is 20%.
Medical Equipment See details
Medical Equipment is covered by the UHC Nursing Home Plan SC-F001 (PPO I-SNP), including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and requires authorization. Prosthetic Devices have a 0-20% coinsurance. Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts each have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered, including diagnostic procedures and tests with a coinsurance of up to 20%, and lab services with no copay. Diagnostic radiological services and therapeutic radiological services are covered with a coinsurance of up to 20%, while outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered under the UHC Nursing Home Plan SC-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 by the UHC Nursing Home Plan SC-F001 (PPO I-SNP) with no copay for days 1-100, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required for this benefit.
Other Services See details
Other Services for UHC Nursing Home Plan SC-F001 (PPO I-SNP) includes Over-the-Counter (OTC) Items with no copay. However, 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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