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UHC Medicare Advantage GA-2 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage GA-2 (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 GA-2 (PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage GA-2 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Georgia. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage GA-2 (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 GA-2 (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 GA-2 (PPO), 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan has a $1000.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $600.00 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 $13900.00 (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 $13900.00 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 GA-2 (PPO) plan features an annual drug deductible of $600. Under this plan, Tier 1 preferred generic drugs have no copay for a 1-month or 3-month supply at standard pharmacies and through mail order. Tier 2 generic drugs carry a $14 copay for a 1-month supply at standard pharmacies, but you can save by using preferred mail order which offers a 3-month supply with no copay. For brand-name and specialty medications, your costs are determined by coinsurance. Tier 3 preferred brand drugs require an 18% coinsurance for both standard pharmacies and mail order. Tier 4 non-preferred drugs carry a 30% coinsurance, while Tier 5 specialty drugs require a 26% coinsurance for a 1-month supply.
Additional Benefits
The UHC Medicare Advantage GA-2 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, preventive services, annual physicals, and home health care. For hospital stays, members pay a $530 copay for days one through three of inpatient care, with no copay for the remaining days, while emergency room visits require a $115 copay. Specialist visits, diagnostic services, and outpatient care feature low to moderate copays with no coinsurance, though certain services like dialysis and durable medical equipment require a 20% coinsurance. This plan also includes valuable supplemental benefits, providing routine vision and hearing exams with no copay, alongside allowances for eyewear and copays for prescription hearing aids. Preventive dental care is fully covered with no copay or coinsurance, though comprehensive dental and cardiac rehabilitation services are not covered. Additionally, members can access skilled nursing facility care with no copay for the first 20 days, as well as over-the-counter items and chronic-illness meal benefits at no cost.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the UHC Medicare Advantage GA-2 (PPO) with no coinsurance, requiring a $530 copay for days 1 through 3 and no copay for days 4 through 90. Unlimited additional acute care days are covered at no copay, while upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Medicare Advantage GA-2 (PPO) with no coinsurance, though prior authorization is required. Ambulatory surgical center and blood services have no copay, outpatient hospital copays range from no copay to $530, and outpatient substance abuse sessions carry copays up to $25.
Partial Hospitalization See details
Partial hospitalization services are covered by the UHC Medicare Advantage GA-2 (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Medicare Advantage GA-2 (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. Transportation services are not covered, meaning trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Medicare Advantage GA-2 (PPO) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Medicare Advantage GA-2 (PPO) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay with no coinsurance. Other covered services, such as therapy and mental health sessions, feature copays ranging from $0 to $55 with no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered under the UHC Medicare Advantage GA-2 (PPO) plan with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, including health education, in-home safety assessments, nutritional therapy, and weight management programs.
Hearing Services See details
UHC Medicare Advantage GA-2 (PPO) provides partially covered hearing services, excluding fitting and evaluation exams as well as inner ear, outer ear, and over the ear prescription hearing aids. Covered benefits include one annual routine exam with no copay and no coinsurance, plus up to two prescription hearing aids (copays of $199 to $1,249) and two OTC hearing aids (copays of $199 to $829) yearly with no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Medicare Advantage GA-2 (PPO) with no deductible and no coinsurance, featuring no copay for annual routine eye exams and a $150 combined eyewear allowance every two years. Covered items include contact lenses and frames with no copay, and lenses with a $0 to $153 copay, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the UHC Medicare Advantage GA-2 (PPO) plan, featuring no copay and no coinsurance for preventive services like exams, cleanings, and fluoride. Medicare-covered dental services require no copay and a 20% coinsurance, while comprehensive services such as restorative, endodontics, periodontics, prosthodontics, oral surgery, and implants are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UHC Medicare Advantage GA-2 (PPO) plan with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
UHC Medicare Advantage GA-2 (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
UHC Medicare Advantage GA-2 (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. Covered DME, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts feature no copay and a 20% coinsurance, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
UHC Medicare Advantage GA-2 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Members pay no copay for lab services, a $25 copay for outpatient X-rays, a $50 copay for diagnostic tests, and copays starting at $60 for therapeutic radiology and starting at no copay for diagnostic radiology.
Home Health Services See details
Home Health Services are covered by the UHC Medicare Advantage GA-2 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Medicare Advantage GA-2 (PPO) plan. None of the associated sub-services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation, are covered by this plan.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage GA-2 (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, but a prior three-day hospital stay is not, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other Services are partially covered by the UHC Medicare Advantage GA-2 (PPO) plan, which offers over-the-counter (OTC) items and chronic-illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required to receive the meal benefit.
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