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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 2025, 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 3.5 out of 5 stars in 2025.
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 $34.00. 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 $255.00 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) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay copays or coinsurance depending on the drug tier and pharmacy. For example, you'll pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs, you'll pay a $47 copay. For preferred brand drugs, you'll pay a $100 copay, while non-preferred drugs have a 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Medicare Advantage VA-0001 (PPO) plan offers a variety of benefits with varying costs. You can expect no copay for many services, including primary care, preventive services, hearing and vision exams, and home health services. However, some services have associated copays, such as inpatient hospital stays, outpatient services, and emergency services, so be sure to review the details. The plan includes coverage for dental, and medical equipment, with coinsurance costs for some services. Additional benefits include coverage for home infusion, dialysis, and skilled nursing facilities with specific copays or coinsurance costs. It's important to note that prior authorization is required for some services, and certain services like cardiac rehabilitation are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $275 copay for days 1-5, and no copay for days 6-90, while additional days have no copay. For Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $275, observation services with a $275 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Medicare Advantage VA-0001 (PPO) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
The UHC Medicare Advantage VA-0001 (PPO) plan covers ambulance services with a $290 copay for both ground and air ambulance services, 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 by the UHC Medicare Advantage VA-0001 (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55; all other services have no copay or coinsurance.
Primary Care See details
The UHC Medicare Advantage VA-0001 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $25, and physician specialist services with a copay between $0 and $35. Mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, and additional telehealth benefits are also covered, with varying copays depending on the service. Opioid treatment program services are covered with no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Additional preventive services, such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
The UHC Medicare Advantage VA-0001 (PPO) plan covers hearing exams with no copay, and routine hearing exams with no copay. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aid, 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 includes coverage for eye exams with no copay, and eyewear coverage that includes contact lenses, eyeglass lenses, and eyeglass frames. Eyeglass lenses have a copay between $0 and $153, and the plan has a combined maximum benefit of $300 for all eyewear every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Medicare Advantage VA-0001 (PPO) plan covers dental services, with a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Prosthodontics (removable and fixed) have a coinsurance of 0-50%, while maxillofacial prosthetics have no copay. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Medicare Advantage VA-0001 (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures and tests with a copay of $20, lab services with no copay, diagnostic radiological services with a copay up to $145, therapeutic radiological services with a copay up to $50, and outpatient X-ray services with a $10 copay. 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 VA-0001 (PPO) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Medicare Advantage VA-0001 (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Medicare Advantage VA-0001 (PPO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, and Meal Benefits also have no copay, though prior authorization is required. Acupuncture, 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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