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UHC Medicare Advantage CT-0003 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage CT-0003 (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-0003 (HMO-POS) in 2026, please refer to our full plan details page.
UHC Medicare Advantage CT-0003 (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-0003 (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-0003 (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-0003 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $6700.00 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-0003 (HMO-POS) plan features an annual drug deductible of $355. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies or through mail order. For Tier 2 generic drugs, standard pharmacy copays are $12 for a one-month supply, while a three-month supply through preferred mail order has no copay. For higher-tier medications, cost sharing transitions to coinsurance percentages instead of flat copays. Tier 3 preferred brand drugs require an 18% coinsurance, while Tier 4 non-preferred drugs carry a 40% coinsurance for a one-month supply. Specialty drugs in Tier 5 are covered with a 29% coinsurance for a one-month supply across standard pharmacies and mail-order options.
Additional Benefits
The UHC Medicare Advantage CT-0003 (HMO-POS) plan offers comprehensive medical coverage with no copays or coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, members can expect no coinsurance and low copays, such as no copay for lab services and a maximum $55 copay for specialist visits. Emergency care requires a $130 copay with no coinsurance, which is waived upon hospital admission, while inpatient hospital stays incur a $550 copay for the first few days before transitioning to no copay. Routine vision and preventive dental services are covered with no copays or coinsurance, though comprehensive dental is not covered and eyewear is subject to a $300 maximum benefit every two years. Hearing aid benefits are available with copayments ranging from $199 to $1,249. For medical equipment, dialysis, and Medicare Part B drugs, members will generally pay a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Medicare Advantage CT-0003 (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute care requires a $550 copay for days 1 through 5 and no copay for days 6 and beyond, while psychiatric care requires a $550 copay for days 1 through 4 and no copay for days 5 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $550, observation services have a $550 daily copay, and outpatient substance abuse sessions range from a $0 to $25 copay, with prior authorization required.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Medicare Advantage CT-0003 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers ground and air ambulance services with a $250 copay and no coinsurance, though prior authorization is required. For transportation benefits, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers emergency services 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 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-0003 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $20 copay and no coinsurance, chiropractic services are only partially covered with routine and other chiropractic care excluded, and other specialty services feature copays from $0 to $45 with no coinsurance.
Preventive Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training. Additional preventive benefits are only partially covered, offering a fitness benefit with no copay or coinsurance but excluding health education, weight management programs, and in-home safety assessments.
Hearing Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) provides partially covered hearing services, which include one routine hearing exam per year with no copay and no coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids (copays of $199 to $1,249) and OTC hearing aids (copays of $199 to $829) are covered up to two per year with no coinsurance, though inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) offers vision services with no deductible, including one annual routine eye exam and contact lenses with no copay and no coinsurance. Eyewear coverage includes a $300 combined maximum benefit every two years, offering frames with no copay and lenses with a copay of $0 to $153, while upgrades, combined eyeglasses, and other eye exams are not covered.
Dental Services See details
Dental services are partially covered by UHC Medicare Advantage CT-0003 (HMO-POS), featuring Medicare-covered dental with no copay and a 20% coinsurance, and preventive services with no copay and no coinsurance. Comprehensive dental care, including restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, is not covered.
Home Infusion bundled Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, insulin, and other drugs carry a coinsurance ranging from 0% to 20%, with insulin specifically requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Medicare Advantage CT-0003 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers medical equipment, including 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
UHC Medicare Advantage CT-0003 (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Lab services and diagnostic radiological services require no copay, while diagnostic procedures cost $5, outpatient x-rays cost $15, and therapeutic radiological services require a minimum copay of $60.
Home Health Services See details
Home health services are covered by UHC Medicare Advantage CT-0003 (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers some cardiac rehabilitation services with no copay and no coinsurance, subject to prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage CT-0003 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but not requiring a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Medicare Advantage CT-0003 (HMO-POS) partially covers other services, providing a meal benefit for chronic illnesses with no copay and no coinsurance, though prior authorization is required. Acupuncture, over-the-counter (OTC) items, and other additional services are not covered under this plan.
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