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UHC Medicare Advantage NH-001A (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage NH-001A (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 NH-001A (PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage NH-001A (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties of New Hampshire. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage NH-001A (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 NH-001A (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 NH-001A (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 $615.00 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 NH-001A (PPO) prescription drug coverage includes an annual drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before your plan begins to cover its share of the costs. Specific drug coverage tier details, including individual copayments and coinsurance rates, are not available for this plan. To determine your exact out-of-pocket expenses, you will need to verify how your specific prescription medications are categorized under this plan's formulary.
Additional Benefits
The UHC Medicare Advantage NH-001A (PPO) plan offers comprehensive medical coverage with no copays for primary care and specialist doctor visits, although a coinsurance of up to 20% may apply. Inpatient hospital stays require a $1,775 copay per stay with no coinsurance, while outpatient services and telehealth visits are available with no copays. Emergency care is covered with a $115 copay, which is waived if you are admitted, and urgent care features a low copay of $0 to $40. This plan also includes valuable supplemental benefits, featuring no copays or coinsurance for routine dental cleanings, annual eye exams, home health services, and up to 24 one-way transportation trips per year. Vision hardware is covered up to a $150 annual limit, and hearing aids are covered up to $1,500 every two years, both with no copay or coinsurance. Additionally, members can access over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
UHC Medicare Advantage NH-001A (PPO) covers inpatient acute and psychiatric hospital stays with a $1,775 copay per stay and no coinsurance, requiring prior authorization. Unlimited additional acute hospital days are covered with no copay, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services covered by UHC Medicare Advantage NH-001A (PPO) feature no copays, with coinsurance ranging from no coinsurance up to 20% depending on the service. This coverage includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with prior authorization required for most care.
Partial Hospitalization See details
Partial hospitalization benefits are covered by UHC Medicare Advantage NH-001A (PPO) with a $55.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Medicare Advantage NH-001A (PPO), which features a 20% coinsurance and no copay for prior-authorized ground and air ambulance services. Transportation benefits are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Medicare Advantage NH-001A (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $0 to $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC Medicare Advantage NH-001A (PPO) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while chiropractic services are not covered. Other benefits like physical therapy and mental health services require no copay and up to 20% coinsurance, while telehealth features no copay and no coinsurance.
Preventive Services See details
UHC Medicare Advantage NH-001A (PPO) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, fitness benefits, home safety devices, kidney education, glaucoma screenings, and diabetes self-management. Covered digital rectal exams and post-welcome visit EKGs require a 20% coinsurance and no copay. Uncovered sub-services include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Medicare Advantage NH-001A (PPO) hearing services include one routine hearing exam annually with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are covered up to $1,500 every two years with no copay or coinsurance, excluding inner, outer, and over-the-ear types, while OTC hearing aids are covered with no copay or coinsurance.
Vision Services See details
UHC Medicare Advantage NH-001A (PPO) partially covers vision services with no copay, no deductible, and no coinsurance for covered care, including one routine eye exam per year and select eyewear. Covered eyewear options like contact lenses, eyeglass lenses, and frames are subject to a $150 combined annual limit, while other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Medicare Advantage NH-001A (PPO) partially covers dental services, providing Medicare-covered dental care with no copay and a 20% coinsurance, alongside preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. However, other diagnostic, restorative, endodontic, periodontic, prosthodontic, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Medicare Advantage NH-001A (PPO) with no copay and no coinsurance, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
The UHC Medicare Advantage NH-001A (PPO) plan covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Medicare Advantage NH-001A (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay, a 20% coinsurance, and prior authorization requirements. Diabetic supplies are limited to specified manufacturers and have no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the UHC Medicare Advantage NH-001A (PPO) plan, with prior authorization required for all services. Diagnostic tests require a copayment and 20% coinsurance, lab services have no copay, and radiological services have no copay, with X-rays and therapeutic radiology requiring 20% coinsurance while diagnostic radiology has no coinsurance.
Home Health Services See details
UHC Medicare Advantage NH-001A (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the UHC Medicare Advantage NH-001A (PPO) plan. This non-coverage applies to all related services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Medicare Advantage NH-001A (PPO) with no coinsurance, though Medicare-defined copays apply and prior authorization is required. This benefit is partially covered because additional days beyond the Medicare-covered limit are not covered, though admission is allowed without a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered under the UHC Medicare Advantage NH-001A (PPO) plan, as acupuncture is not covered, but over-the-counter (OTC) items and chronic illness meal benefits are provided with no copay and no coinsurance. Prior authorization is required for the meal benefit, and the OTC benefit covers nicotine replacement therapy and naloxone through claims processing and reimbursement.
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