A non-government entity
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 2026, 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 2026.
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 $35.70. 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 $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 SC-F001 (PPO I-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) features an annual prescription drug deductible of $615. You will need to pay this deductible amount out-of-pocket for your covered medications before the plan begins to pay its share. Because specific drug coverage tier details are currently unavailable, it is important to verify how your specific medications are classified. Understanding your prescription drug costs is essential when choosing a Medicare Advantage plan. To get a complete picture of your potential copays and coinsurance, you should contact the plan directly for detailed formulary and tier pricing. This ensures you avoid unexpected out-of-pocket expenses for your essential medications.
Additional Benefits
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) offers robust medical coverage with many essential services featuring no copayments. Inpatient hospital stays require a $2,025 copay per benefit period with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted within 24 hours. Most outpatient, primary care, specialist, and diagnostic services feature no copay, though they may require a coinsurance of up to 20%. For daily and routine care, members benefit from no copays and no coinsurance on home health care, preventive services, and skilled nursing facility stays up to 100 days. Dental, vision, and hearing benefits are partially covered with no copays, though routine exams generally carry a 20% coinsurance. Additionally, this plan covers over-the-counter items and up to 48 one-way transportation trips per year to approved health locations with no copay or coinsurance.
Inpatient Hospital See details
UHC Nursing Home Plan SC-F001 (PPO I-SNP) partially covers inpatient hospital services, as additional days, upgrades, and non-Medicare-covered stays are not covered. Covered acute and psychiatric stays require prior authorization and have a $2,025 copayment per Original Medicare benefit period and no coinsurance.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP) with no copays, though prior authorization and coinsurance apply to most services. Covered benefits—including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services—feature no copay, with coinsurance ranging from no coinsurance up to 20% depending on the specific service.
Partial Hospitalization See details
UHC Nursing Home Plan SC-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
Ambulance and transportation services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP), featuring a 20% coinsurance and no copay for both ground and air ambulance services. Transportation benefits are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Nursing Home Plan SC-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 no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
UHC Nursing Home Plan SC-F001 (PPO I-SNP) covers primary care, specialist, mental health, and therapy services with no copay and coinsurance ranging from 0% to 20%, though routine chiropractic services are not covered. Telehealth and opioid treatment are covered with no copay and no coinsurance, while routine podiatry is covered for up to 6 annual visits with a 20% coinsurance and no copay.
Preventive Services See details
Preventive Services are partially covered by the UHC Nursing Home Plan SC-F001 (PPO I-SNP), featuring no copay and no coinsurance for annual physical exams, kidney disease education, and home safety modifications. A 20% coinsurance and no copay apply to glaucoma screenings, digital rectal exams, and post-welcome visit EKGs, while various supplemental benefits such as fitness and health education are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP), featuring no deductibles, no copays for covered services, and a 20% coinsurance for routine hearing exams. Prescription and OTC hearing aids have no copay and no coinsurance, with prescription aids limited to a $2,200 maximum benefit every two years. However, fitting and evaluation exams, as well as 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 SC-F001 (PPO I-SNP), featuring one routine eye exam per year with no copay and 20% coinsurance, while other eye exam services are not covered. Covered eyewear, including contact lenses, eyeglass lenses, and frames, has no copay and no coinsurance up to a $300 annual maximum, but upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Nursing Home Plan SC-F001 (PPO I-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Preventive services such as oral exams, cleanings, X-rays, and fluoride treatments are covered with no copay and no coinsurance, whereas restorative, endodontic, periodontic, orthodontic, oral surgery, and prosthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP) with no copay, although prior authorization is required. Covered Medicare Part B chemotherapy and other drugs carry no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical Equipment benefits under the UHC Nursing Home Plan SC-F001 (PPO I-SNP) are covered with no copay, requiring a 20% coinsurance for durable medical equipment, medical supplies, and diabetic equipment. Prosthetic devices require between no coinsurance and 20% coinsurance, and prior authorization is required for all of these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP) with prior authorization required. Diagnostic tests require a copayment and 20% coinsurance, lab services have no copay, and radiological services feature no copay, with a 20% coinsurance for therapeutic and X-ray services and no coinsurance for diagnostic radiology.
Home Health Services See details
The UHC Nursing Home Plan SC-F001 (PPO I-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
UHC Nursing Home Plan SC-F001 (PPO I-SNP) covers some Cardiac Rehabilitation Services with no copay and prior authorization, though several key services are not covered in practice. Specifically, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Nursing Home Plan SC-F001 (PPO I-SNP) for days 1 through 100 with no copayment and no coinsurance, though prior authorization is required. A prior three-day inpatient hospital stay is not required for admission, but additional days beyond the standard 100 days are not covered.
Other Services See details
UHC Nursing Home Plan SC-F001 (PPO I-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved