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UHC The Villages Medicare Advantage FL-004P (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC The Villages Medicare Advantage FL-004P (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC The Villages Medicare Advantage FL-004P (HMO-POS) in 2026, please refer to our full plan details page.
UHC The Villages Medicare Advantage FL-004P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Lake, Marion, and Sumter Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC The Villages Medicare Advantage FL-004P (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 The Villages Medicare Advantage FL-004P (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 The Villages Medicare Advantage FL-004P (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. Additionally, this plan comes with a Part B Premium reduction of $35.00. 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 a $270.00 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 $2400.00 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 The Villages Medicare Advantage FL-004P (HMO-POS) plan features an annual drug deductible of $270. Under this plan, you will enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs purchased at standard pharmacies or through standard mail order. This coverage applies to both one-month and three-month supplies, making essential everyday medications highly affordable. For brand-name and specialty prescriptions, the plan utilizes coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs carry a 39% coinsurance. Specialty medications in Tier 5 are covered with a 30% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The UHC The Villages Medicare Advantage FL-004P (HMO-POS) plan offers comprehensive medical coverage with highly affordable cost-sharing options. You will enjoy no copay and no coinsurance for primary care visits, telehealth services, preventive care, and home health services. Specialist visits range from no copay up to a $35 copay, while inpatient hospital stays require a $150 copay per stay with no coinsurance. For auxiliary care, the plan features no copay and no coinsurance for routine hearing and preventive dental services, alongside dental comprehensive options with 50% coinsurance. Diagnostic laboratory services and home infusion services are also available with no copay, while diagnostic radiology and vision services start with no copay. Additionally, durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) partially covers inpatient hospital services with a $150 copay per stay and no coinsurance for Medicare-covered acute and psychiatric stays. Unlimited additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers outpatient services with no coinsurance, featuring a copay of $0 to $150 for outpatient hospital services and a $150 daily copay for observation services. There is no copay or coinsurance for ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by UHC The Villages Medicare Advantage FL-004P (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers Medicare-approved ground and air ambulance services with a $100 copay and no coinsurance, though prior authorization is required. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the UHC The Villages Medicare Advantage FL-004P (HMO-POS) plan with a $150 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 $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) provides primary care, telehealth, psychiatric, and mental health services with no copay and no coinsurance. Specialist visits require a $0 to $35 copay, therapy services have a $5 copay, and podiatry has a $35 copay, all with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes training. Additional preventive services are partially covered, offering fitness benefits and home safety devices with no copay or coinsurance, while services like health education, weight management, and in-home support are not covered.
Hearing Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers annual routine hearing exams with no copay and no coinsurance, though fitting and evaluation services are not covered. Up to two prescription or OTC hearing aids are covered per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC The Villages Medicare Advantage FL-004P (HMO-POS), offering routine eye exams and select eyewear with no deductible, no coinsurance, and copays ranging from $0 to $153. While routine exams and eyewear are covered up to a $150 limit every two years, other eye exam services, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC The Villages Medicare Advantage FL-004P (HMO-POS), with implant services and orthodontics excluded from coverage. Preventive services feature no copay and no coinsurance up to a $5,000 annual limit, while comprehensive services require no copay and 50% coinsurance, and Medicare-covered dental services have no copay and 20% coinsurance.
Home Infusion bundled Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs require no coinsurance up to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC The Villages Medicare Advantage FL-004P (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers 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, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers diagnostic and radiological services with no coinsurance, subject to prior authorization. Lab services have no copay, diagnostic procedures and outpatient X-rays require a $5 copay, therapeutic radiology has a $10 copay, and diagnostic radiology services start at no copay.
Home Health Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC The Villages Medicare Advantage FL-004P (HMO-POS) with no coinsurance, although only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered by this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC The Villages Medicare Advantage FL-004P (HMO-POS) with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond those covered by Medicare are not covered.
Other Services See details
UHC The Villages Medicare Advantage FL-004P (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture is not covered under this plan.
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