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UHC Preferred Medicare Advantage FL-0001 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Preferred Medicare Advantage FL-0001 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Preferred Medicare Advantage FL-0001 (HMO) in 2025, please refer to our full plan details page.
UHC Preferred Medicare Advantage FL-0001 (HMO) is a HMO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Miami-Dade County. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Preferred Medicare Advantage FL-0001 (HMO) 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 Preferred Medicare Advantage FL-0001 (HMO).
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 Preferred Medicare Advantage FL-0001 (HMO), 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. Additionally, this plan comes with a Part B Premium reduction of $18.00. You must continue to pay paying your reduced 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2900.00 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 Preferred Medicare Advantage FL-0001 (HMO) plan has an enhanced alternative drug benefit. The plan has no deductible. In the initial coverage phase, you will pay no copay for standard generic drugs. For preferred brand drugs, the copay is $40.00. For non-preferred drugs, you will pay 33% coinsurance. Once your total drug costs reach $2000.00, you enter the next coverage phase.
Additional Benefits
The UHC Preferred Medicare Advantage FL-0001 (HMO) plan offers comprehensive coverage with a focus on outpatient services, and preventive care, with many services available at no copay. The plan covers a wide range of services, including primary care, hearing, vision, and dental, as well as home health services and medical equipment, often with no copay. Emergency services and ambulance services are covered, with copays ranging from $90 to $120. Inpatient hospital stays have no copay, and skilled nursing facility stays have no copay for the first 20 days, and a $25 copay for days 21-100. The plan also includes coverage for prescription hearing aids, with copays ranging from $199 to $1249. Some services like Cardiac Rehabilitation, and Routine Chiropractic Care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan. For Inpatient Hospital-Acute, there is no copay for a Medicare-covered stay, and additional days (91-999) have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $75, and observation services have a $75 copay, while ambulatory surgical center services, individual sessions for outpatient substance abuse, group sessions for outpatient substance abuse and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan. Ground and air ambulance services have a $120 copay, while transportation services to a plan-approved health-related location have no copay for up to 60 one-way trips per year, but transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan. Emergency Services have a $90 copay, while Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay. There is no coinsurance for any of these services.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services (Individual and Group Sessions), Podiatry Services (including Routine Foot Care), Other Health Care Professional, Psychiatric Services (Individual and Group Sessions), Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with no copay for most services. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services with no copay, an annual physical exam with no copay, and additional preventive services including fitness benefit, home and bathroom safety devices, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. Other services like health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and more are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for 1 visit per year with no copay. Prescription hearing aids are covered with a copay between $199 and $1249 for all types, and OTC hearing aids are covered with a copay between $99 and $829. 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
Vision Services include eye exams and eyewear, with no copay for eye exams, contact lenses, eyeglasses (lenses and frames), and upgrades. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services include oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, prosthodontics (removable), and oral and maxillofacial surgery with no copay; however, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered. Oral exams and dental x-rays are limited to 2 and 1 visit per year, respectively, while prophylaxis and fluoride treatment are limited to 1 visit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered with a 20% coinsurance. Prior authorization is required.
Medical Equipment See details
Medical Equipment is covered by UHC Preferred Medicare Advantage FL-0001 (HMO), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and no coinsurance, while Prosthetic Devices have a coinsurance of 0-20%, and Medical Supplies have no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Preferred Medicare Advantage FL-0001 (HMO) plan. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan with no copay and no coinsurance, although authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Preferred Medicare Advantage FL-0001 (HMO) plan, but require prior authorization. There is no copay for days 1-20, and a $25 copay for days 21-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and meal benefits, with OTC items having no copay, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, and the other listed services are not covered. Meal benefits have no copay, and require prior authorization.
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