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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 2025, 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 2025.
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 $340.00 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 has an enhanced alternative drug benefit. The plan has a deductible of $340.00. In the initial coverage phase, after the deductible, you will pay a $12 copay for tier 1 drugs at a standard pharmacy, and a $47 copay for tier 2 drugs at a standard pharmacy. For tier 3 drugs, you will pay a $100 copay. For tier 4 drugs, you will pay 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The UHC Medicare Advantage CT-0003 (HMO-POS) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and primary care visits may have copays depending on the specific service. Other benefits include coverage for ambulance, emergency, and hearing services, as well as vision and dental care with no copays for some services. Additional covered services include home health, skilled nursing, and cardiac rehabilitation, with a 20% coinsurance for dialysis and medical equipment. Preventive services, such as annual physical exams, are available with no copay. The plan also covers services such as hearing and vision exams with no copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $450 copay for days 1-4, and no copay for days 5-90, and for Inpatient Hospital Psychiatric, you will pay a $450 copay for days 1-3, and no copay for days 4-90. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $450, observation services have a $450 copay, ambulatory surgical center services have no copay, outpatient substance abuse individual sessions have a copay between $0 and $25, outpatient substance abuse group sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Medicare Advantage CT-0003 (HMO-POS) plan. Ground and air ambulance services have a $275 copay, with 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 no coinsurance, while Urgently Needed Services have a copay between $0 and $55 and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Under the UHC Medicare Advantage CT-0003 (HMO-POS) plan, primary care physician services have no copay, chiropractic services have a $20 copay, and occupational therapy services have a copay between $0 and $30. Physician specialist services have a copay between $0 and $45, and mental health specialty services, psychiatric services, and opioid treatment program services have varying copays. Podiatry services have a $45 copay, other health care professional services have a copay between $0 and $45, physical therapy and speech-language pathology services have a copay between $0 and $30, and additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar services, annual physical exams with no copay, and other preventive services with no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. Health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Routine hearing exams are covered with no copay, but are limited to 1 per year. Prescription hearing aids are partially covered, with copays between $199 and $1249 for all types of prescription hearing aids, but not for inner ear, outer ear, or over the ear hearing aids. OTC hearing aids are covered with a copay between $99 and $829, and are limited to 2 per year.
Vision Services See details
The UHC Medicare Advantage CT-0003 (HMO-POS) plan covers vision services, including eye exams with no copay and eyewear with no copay for contact lenses and eyeglass frames, but eyeglasses (lenses and frames) and upgrades are not covered. Routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames are also covered with no copay.
Dental Services See details
The UHC Medicare Advantage CT-0003 (HMO-POS) plan covers Medicare dental services with a 20% coinsurance, oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. However, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics, fixed, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs. For Medicare Part B Insulin Drugs, you will pay a $35 copay, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Medicare Advantage CT-0003 (HMO-POS) plan, with prior authorization required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with a 20% coinsurance and requires authorization, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Equipment which includes Diabetic Supplies with no copay, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a copay for diagnostic procedures and tests that is at most $50, and lab services with no copay, as well as coverage for all radiological services with a copay for diagnostic and therapeutic radiological services, a coinsurance of at most 20% for therapeutic radiological services, and a $25 copay for outpatient X-ray services. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered under the UHC Medicare Advantage CT-0003 (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Medicare Advantage CT-0003 (HMO-POS) plan, with a $0 copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include a meal benefit with no copay, but acupuncture, over-the-counter items, 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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