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UHC Medicare Advantage CT-0002 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage CT-0002 (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-0002 (HMO-POS) in 2026, please refer to our full plan details page.
UHC Medicare Advantage CT-0002 (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-0002 (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-0002 (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-0002 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.00. 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 $6400.00 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-0002 (HMO-POS) plan features an annual drug deductible of $355. Tier 1 preferred generic drugs are highly affordable, offering no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. For Tier 2 generic medications, you will pay a $10 copay for a 1-month supply at standard pharmacies, or you can opt for a 3-month supply with no copay through preferred mail order. Higher-tier prescription drugs under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 17% coinsurance for both standard pharmacies and mail order options. Non-preferred drugs in Tier 4 require a 40% coinsurance, while Tier 5 specialty drugs incur a 29% coinsurance for a 1-month supply.
Additional Benefits
The UHC Medicare Advantage CT-0002 (HMO-POS) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, preventive care, and annual physical exams. Specialist visits are highly affordable, ranging from no copay to a $50 copay, while emergency room services require a $130 copay that is waived upon hospital admission. For inpatient hospital stays, members pay a $455 daily copay for the first five to six days with no coinsurance, followed by no copay for subsequent days. Routine dental, vision, and hearing exams are also covered with no copay or coinsurance, though prescription hearing aids and lens upgrades require copayments. Many diagnostic services, lab tests, and home health services feature no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Additionally, the plan covers over-the-counter items with no copay and provides skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
UHC Medicare Advantage CT-0002 (HMO-POS) inpatient hospital services are partially covered with no coinsurance, requiring a $455 daily copay for days 1-6 of acute stays and days 1-5 of psychiatric stays, followed by no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the UHC Medicare Advantage CT-0002 (HMO-POS) plan are covered with no coinsurance, though prior authorization is required. Ambulatory surgical center and outpatient blood services feature no copay and no coinsurance, with no deductible for blood services. Outpatient hospital copays range from $0 to $455, and outpatient substance abuse services require no coinsurance with copays of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Medicare Advantage CT-0002 (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 partially covered by UHC Medicare Advantage CT-0002 (HMO-POS), with ground and air ambulance services requiring a $290 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by UHC Medicare Advantage CT-0002 (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 feature a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits carry a copay of $0 to $50 and no coinsurance. Physical, occupational, and speech therapies require a $20 copay and no coinsurance, whereas some chiropractic services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not.
Preventive Services See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers preventive services—including annual physical exams, fitness benefits, home safety devices, kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, and EKGs—with no copay and no coinsurance. However, this benefit is only partially covered, as health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services are not covered.
Hearing Services See details
UHC Medicare Advantage CT-0002 (HMO-POS) provides partially covered hearing services, including one annual routine hearing exam with no copay or coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids (with copays ranging from $199 to $1,249) and two OTC hearing aids (with copays ranging from $199 to $829) are covered per year with no coinsurance, though inner, outer, and over-the-ear prescription types are excluded.
Vision Services See details
Vision services are partially covered by UHC Medicare Advantage CT-0002 (HMO-POS), featuring no deductibles, no coinsurance, and no copays for routine eye exams, contact lenses, and eyeglass frames, with a $0 to $153 copay for eyeglass lenses. A $150 combined eyewear limit applies every two years, but other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the UHC Medicare Advantage CT-0002 (HMO-POS) plan, featuring preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental services with no copay and 20% coinsurance. Comprehensive options such as restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Medicare Advantage CT-0002 (HMO-POS) plan with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic services, with prior authorization required. These benefits feature no copays, but a 20% coinsurance applies to DME, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts, with diabetic supplies limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Medicare Advantage CT-0002 (HMO-POS) plan with no coinsurance, though prior authorization is required. Members pay no copay for lab services, a $5 copay for diagnostic tests and outpatient X-rays, and copays starting at no copay for diagnostic radiology and $60 for therapeutic radiology.
Home Health Services See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the UHC Medicare Advantage CT-0002 (HMO-POS) plan require prior authorization and feature no copay and no coinsurance. While the benefit is technically covered, only some services are covered, and cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage CT-0002 (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coverage provided for days beyond the standard Medicare limit.
Other Services See details
UHC Medicare Advantage CT-0002 (HMO-POS) provides partial coverage for other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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