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UHC Medicare Advantage CT-0001 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage CT-0001 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Medicare Advantage CT-0001 (HMO-POS) in 2025, please refer to our full plan details page.
UHC Medicare Advantage CT-0001 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Connecticut. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Medicare Advantage CT-0001 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Medicare Advantage CT-0001 (HMO-POS).
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 Medicare Advantage CT-0001 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $79.00. 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 $255.00 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 Maximum Out-Of-Pocket cost of $5900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 Medicare Advantage CT-0001 (HMO-POS) plan has a $255 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. For example, you'll pay an $8 copay for preferred generic drugs at a standard pharmacy, and 30% coinsurance for non-preferred drugs. Once your total yearly drug costs reach $2,000, you will enter the catastrophic coverage phase where you will pay nothing for your prescriptions.
Additional Benefits
The UHC Medicare Advantage CT-0001 (HMO-POS) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays. Emergency, primary care, preventive, hearing, vision, and dental services are also covered, with some services having no copay. The plan also includes coverage for ambulance, home health, and medical equipment, with specific copays and coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $395 for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric services are covered, with a copay of $395 for days 1-5 and no copay for days 6-90, and the Additional Days and Non-Medicare-covered Stay sub-services are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $395, observation services with a $395 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Medicare Advantage CT-0001 (HMO-POS) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $275 copay for both ground and air ambulance services, and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55, while Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay, while Chiropractic Services have a $20 copay, Physician Specialist Services have a $0-$35 copay, Mental Health Specialty Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions, Podiatry Services have a $35 copay, Other Health Care Professional services have a $0-$35 copay, Psychiatric Services have a $0-$25 copay for individual sessions and a $15 copay for group sessions, and Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
The UHC Medicare Advantage CT-0001 (HMO-POS) plan covers preventive services, including an annual physical exam with no copay, and additional preventive services with a copay. The plan also covers other preventive services, such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are limited to one per year. Prescription Hearing Aids are covered with a copay between $199 and $1249, with a limit of two per year, and OTC Hearing Aids are covered with a copay between $99 and $829, with a limit of two 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.
Vision Services See details
The UHC Medicare Advantage CT-0001 (HMO-POS) plan covers vision services including eye exams with no copay, and eyewear with a combined maximum of $250 every two years. Eyeglass lenses have a copay of $0-$153, and eyeglass frames are covered with no copay; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, cleaning, fluoride treatments, and other preventive dental services. Medicare Dental Services have a 20% coinsurance and require prior authorization, while oral exams, dental x-rays, cleaning, fluoride treatments, and other preventive services have no copay.
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 a coinsurance between 0% and 20%, depending on the specific drug. Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs are covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Medicare Advantage CT-0001 (HMO-POS) plan and require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Diabetic Supplies have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a $50 copay for Diagnostic Procedures/Tests and no copay for Lab Services. Diagnostic Radiological Services have a copay up to $250, while Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Medicare Advantage CT-0001 (HMO-POS) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the UHC Medicare Advantage CT-0001 (HMO-POS) plan, but not in practice because Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Medicare Advantage CT-0001 (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The UHC Medicare Advantage CT-0001 (HMO-POS) plan covers over-the-counter items with no copay, and meal benefits with no copay. Acupuncture, 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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