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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 2026, 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 2026.
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 $78.00. 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 $355.00 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 an annual prescription drug deductible of $355. For Tier 1 preferred generics, there is no copay for a 1-month or 3-month supply at standard pharmacies or through mail order. Tier 2 generic drugs cost an $8 copay for a 1-month supply at standard pharmacies, but you can get a 3-month supply with no copay through preferred mail order. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require an 18% coinsurance for 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 4 non-preferred drugs require a 42% coinsurance, and Tier 5 specialty drugs require a 29% coinsurance for a 1-month supply.
Additional Benefits
The UHC Medicare Advantage CT-0001 (HMO-POS) plan offers comprehensive medical coverage with predictable costs, featuring no copay and no coinsurance for primary care visits, telehealth services, and annual preventive exams. Specialist visits require a copay ranging from $0 to $45, while emergency room visits carry a $130 copay that is waived if you are admitted. For hospital stays, members pay a $425 daily copay for the first six days of acute inpatient care, with no copay required for additional days. Routine dental, vision, and hearing services are partially covered, including annual hearing and eye exams with no copay, plus up to a $300 allowance for eyewear every two years. While home health services require no copay, other services like skilled nursing facilities feature no copay for the first 20 days followed by a $218 daily copay. Durable medical equipment and dialysis services are covered with no copay and a standard 20% coinsurance.
Inpatient Hospital See details
UHC Medicare Advantage CT-0001 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1-6 of acute stays (no copay for days 7 and beyond) and a $425 daily copay for days 1-5 of psychiatric stays (no copay for days 6-90). This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Medicare Advantage CT-0001 (HMO-POS) covers outpatient services with no coinsurance, featuring copays of $0 to $425 for hospital services and $425 per day for observation services. Ambulatory surgical center and blood services have no copay or coinsurance, while outpatient substance abuse services have no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Medicare Advantage CT-0001 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Medicare Advantage CT-0001 (HMO-POS), offering ground and air ambulance services with a $270 copay, no coinsurance, and prior authorization requirements. However, transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Emergency services are covered by UHC Medicare Advantage CT-0001 (HMO-POS) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
UHC Medicare Advantage CT-0001 (HMO-POS) provides primary care physician visits and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical, occupational, and speech therapies require a $35 copay with no coinsurance, and routine podiatry is covered for a $45 copay with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the UHC Medicare Advantage CT-0001 (HMO-POS) plan with no copay and no coinsurance for covered care such as annual physical exams, fitness benefits, and kidney disease education. Several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Medicare Advantage CT-0001 (HMO-POS) provides partially covered hearing services with no deductible and no coinsurance, including one annual routine hearing exam with no copay. Prescription hearing aids (copays of $199 to $1,249) and OTC hearing aids (copays of $199 to $829) are covered up to two devices per year, but fitting and evaluation exams alongside inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Medicare Advantage CT-0001 (HMO-POS), featuring one annual routine eye exam with no copay and no coinsurance. Eyewear is also covered with no coinsurance up to a $300 combined limit every two years, including contact lenses and frames with no copay, and eyeglass lenses with a $0 to $153 copay, though upgrades, combined eyeglasses, and other eye exam services are not covered.
Dental Services See details
UHC Medicare Advantage CT-0001 (HMO-POS) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, alongside preventive services like exams and cleanings with no copay and no coinsurance. However, several services are not covered, including restorative services, endodontics, periodontics, prosthodontics, implants, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Medicare Advantage CT-0001 (HMO-POS) with no copay, though prior authorization is required. Covered Medicare Part B drugs, such as chemotherapy and insulin, carry a coinsurance of 0% to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by UHC Medicare Advantage CT-0001 (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Medicare Advantage CT-0001 (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under UHC Medicare Advantage CT-0001 (HMO-POS) with no coinsurance, though prior authorization is required. Members pay no copay for lab services and diagnostic radiological services, a $5 copay for outpatient X-rays and diagnostic tests, and a $60 copay for therapeutic radiological services.
Home Health Services See details
Home health services are covered by UHC Medicare Advantage CT-0001 (HMO-POS) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
UHC Medicare Advantage CT-0001 (HMO-POS) features Cardiac Rehabilitation Services with no copay, no coinsurance, and prior authorization requirements, though the benefit is not covered in practice. Specifically, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered by this plan.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage CT-0001 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Medicare Advantage CT-0001 (HMO-POS) partially covers other services, offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, though meals require prior authorization. Acupuncture and other additional services under this category are not covered.
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