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UHC Medicare Advantage VA-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage VA-0001 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Medicare Advantage VA-0001 (PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage VA-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Virginia. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage VA-0001 (PPO) 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 VA-0001 (PPO).
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 VA-0001 (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.00. 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 $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 combined Maximum Out-Of-Pocket cost of $10100.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 VA-0001 (PPO) prescription drug plan features an annual drug deductible of $270. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using standard pharmacies or standard mail order. This includes no copay for both 1-month and 3-month supplies of these generic medications. For brand-name and specialty medications, your costs are determined by coinsurance. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs carry a 43% coinsurance. Specialty medications in Tier 5 have a 30% coinsurance for a 1-month supply through standard pharmacies or standard mail order.
Additional Benefits
The UHC Medicare Advantage VA-0001 (PPO) plan offers comprehensive healthcare coverage with no copay for primary care visits, preventive services, and routine eye or hearing exams. For inpatient hospital stays, members pay a $275 daily copay for days 1 to 5 and no copay for days 6 to 90. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. Specialist visits feature a copay ranging from $0 to $30, while dental benefits cover preventive care with no copay and comprehensive care up to a $5,000 annual limit with 50% coinsurance. Home health care is fully covered with no copay, and there is no copay for routine eyewear up to a $300 limit every two years. Durable medical equipment, dialysis, and Part B drugs generally require a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Medicare Advantage VA-0001 (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $275 daily copay for days 1 to 5 and no copay for days 6 to 90. This benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
UHC Medicare Advantage VA-0001 (PPO) covers outpatient hospital services with no coinsurance and a copay ranging from no copay to $275, alongside observation services at a $275 daily copay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services carry no coinsurance and copays ranging from no copay to $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Medicare Advantage VA-0001 (PPO) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Medicare Advantage VA-0001 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, although prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
UHC Medicare Advantage VA-0001 (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services are covered with a copay ranging from $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services are covered under the UHC Medicare Advantage VA-0001 (PPO) with no coinsurance, featuring no copay for primary care visits, telehealth, and opioid treatment. Specialist and other professional visits range from a $0 to $30 copay, therapy services require a $25 copay, and chiropractic care is only partially covered as routine and other chiropractic services are not covered.
Preventive Services See details
UHC Medicare Advantage VA-0001 (PPO) offers preventive services with no copay and no coinsurance, covering annual physical exams, kidney disease education, glaucoma screenings, diabetes training, fitness benefits, and home safety devices. However, this benefit is only partially covered, and services such as health education, in-home safety assessments, personal emergency response systems (PERS), and medical nutrition therapy are not covered.
Hearing Services See details
UHC Medicare Advantage VA-0001 (PPO) provides partially covered hearing services with no deductible, including annual routine hearing exams for no copay and no coinsurance, though fitting and evaluation services are not covered. Prescription hearing aids are partially covered with a $199 to $1,249 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models, while OTC hearing aids are covered with a $199 to $829 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Medicare Advantage VA-0001 (PPO) with no coinsurance, featuring routine eye exams with no copay, and eyewear up to a $300 limit every two years with no copay for frames and contact lenses and a $0 to $153 copay for lenses. Other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
UHC Medicare Advantage VA-0001 (PPO) offers partially covered dental services up to a $5,000 annual limit, though implant services and orthodontics are not covered. Preventive care is available with no copay and no coinsurance, while Medicare-covered dental services require a 20% coinsurance and comprehensive dental services require a 50% coinsurance, both with no copay.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Medicare Advantage VA-0001 (PPO) with no copay, though prior authorization is required. Medicare Part B chemotherapy and other Part B drugs feature coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by UHC Medicare Advantage VA-0001 (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment benefits under UHC Medicare Advantage VA-0001 (PPO) require prior authorization and cover durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts require a copay and 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Medicare Advantage VA-0001 (PPO) covers diagnostic services with no coinsurance, featuring a $20 copay for diagnostic tests and no copay for lab services. Covered radiological services require prior authorization and include no copay for diagnostic radiology, a $5 copay for outpatient x-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the UHC Medicare Advantage VA-0001 (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no copay and no coinsurance under the UHC Medicare Advantage VA-0001 (PPO) plan, though only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require prior authorization.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage VA-0001 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
UHC Medicare Advantage VA-0001 (PPO) provides partial coverage for other services, offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
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