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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 2026, 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 4.5 out of 5 stars in 2026.
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 $25.00. 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 features a $0 drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generic, Tier 2 generic, and Tier 3 preferred brand medications, there is no copay for one-month or three-month supplies at standard pharmacies and standard mail order. This comprehensive coverage ensures that many common prescription drugs are available to plan members at no cost. For higher-tier medications, the plan utilizes a coinsurance model instead of flat copayments. Tier 4 non-preferred drugs require a 40% coinsurance for a one-month supply at standard pharmacies and standard mail order. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply through standard pharmacies and mail order services.
Additional Benefits
The UHC Preferred Medicare Advantage FL-0001 (HMO) plan offers comprehensive healthcare coverage, featuring no copays and no coinsurance for inpatient hospital stays, primary care, specialist visits, and diagnostic services. Outpatient hospital services feature low copays ranging from $0 to $75, while emergency room visits carry a $150 copay which is waived if you are admitted. Members also pay no copay or coinsurance for preventive care, routine dental services, annual eye exams, and home health care. For specialized care, the plan covers routine hearing exams with no copay, though hearing aids require a copay ranging from $199 to $1,249. Durable medical equipment is fully covered with no copay, while dialysis and prosthetic devices require up to 20% coinsurance. Additional benefits include no-copay routine transportation for up to 60 one-way trips annually and a $0 copay for over-the-counter items.
Inpatient Hospital See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers inpatient acute and psychiatric hospital stays with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered.
Outpatient Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers outpatient services with no coinsurance, though prior authorization is required. Members pay no copay for ambulatory surgical center, outpatient substance abuse, and blood services, while outpatient hospital and daily observation services have a copay ranging from $0 to $75.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Preferred Medicare Advantage FL-0001 (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the UHC Preferred Medicare Advantage FL-0001 (HMO) plan, featuring a $110 copay and no coinsurance for both ground and air ambulance rides. Transportation benefits are partially covered with no copay and no coinsurance for up to 60 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay to a $5 copay and no coinsurance, while worldwide emergency, urgent, and transportation services feature no copay and no coinsurance.
Primary Care See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers primary care, specialist, therapy, mental health, podiatry, and telehealth services with no copay and no coinsurance. Although some chiropractic services are covered, routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Preferred Medicare Advantage FL-0001 (HMO) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, and home safety devices. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, and therapeutic massage. Also excluded are adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling services.
Hearing Services See details
Hearing services are partially covered by UHC Preferred Medicare Advantage FL-0001 (HMO), which offers one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are covered with no coinsurance and a copay of $199.00 to $1,249.00 for up to two devices annually, excluding inner ear, outer ear, and over the ear models. OTC hearing aids are also covered with a $199.00 to $829.00 copay and no coinsurance for up to two devices per year.
Vision Services See details
Vision services are partially covered by UHC Preferred Medicare Advantage FL-0001 (HMO) with no copay and no coinsurance, including one routine eye exam per year (prior authorization required) and a $300 annual maximum for contact lenses, upgrades, and eyeglasses. Other eye exams, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Preferred Medicare Advantage FL-0001 (HMO), providing covered benefits like exams, cleanings, x-rays, fluoride, restorative care, removable prosthodontics, and oral surgery with no copay and no coinsurance. Non-covered services include other diagnostic and preventive services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Preferred Medicare Advantage FL-0001 (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs carry 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the UHC Preferred Medicare Advantage FL-0001 (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Preferred Medicare Advantage FL-0001 (HMO) with no copay and no coinsurance for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices require a 0% to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts have a 20% coinsurance and no copay, with prior authorization required for most items.
Diagnostic and Radiological Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers diagnostic and radiological services, including lab tests, therapeutic radiology, and outpatient X-rays, with no copay and no coinsurance. Prior authorization is required for these covered services.
Home Health Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. However, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Preferred Medicare Advantage FL-0001 (HMO) with no coinsurance and does not require a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $25 daily copay for days 21 through 100, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Preferred Medicare Advantage FL-0001 (HMO) partially covers other services, which include over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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