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UHC Medicare Advantage TC-0001 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage TC-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 TC-0001 (PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage TC-0001 (PPO) is a PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Tennessee and Virginia. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage TC-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 TC-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 TC-0001 (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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $440.00 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 TC-0001 (PPO) prescription drug plan features an annual drug deductible of $440. Under this plan, Tier 1 preferred generic drugs have no copay for a one-month or three-month supply at standard pharmacies, as well as three-month mail orders. For Tier 2 generic drugs, you will pay a $10 copay for a one-month supply at standard pharmacies, while a three-month preferred mail order has no copay. Higher-tier medications are subject to coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 16% coinsurance for standard pharmacy and mail order fills. Non-preferred drugs in Tier 4 carry a 42% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a one-month supply.
Additional Benefits
The UHC Medicare Advantage TC-0001 (PPO) plan offers robust coverage with no copay and no coinsurance for primary care, telehealth, and preventive services. For specialized medical care, members pay predictable copays with no coinsurance, including up to $45 for specialist visits and a $395 daily copay for the first few days of inpatient hospital stays. Emergency services require a $130 copay, which is waived if you are admitted, while urgent care ranges from no copay to a $50 copay. Routine vision exams, hearing exams, and preventive dental cleanings are covered with no copay and no coinsurance. For durable medical equipment and dialysis, members pay no copay and a 20% coinsurance. Specialty benefits like hearing aids and select eyewear are also available with set copays and no coinsurance to help manage your healthcare expenses.
Inpatient Hospital See details
UHC Medicare Advantage TC-0001 (PPO) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $395 for days 1 through 6 of acute stays and days 1 through 5 of psychiatric stays, with no copay for remaining covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Medicare Advantage TC-0001 (PPO) with no coinsurance, featuring copays ranging from no copay up to $395 for hospital and observation services. Ambulatory surgical center and blood services require no copay and no coinsurance, while outpatient substance abuse services feature copays ranging from no copay to $25 with no coinsurance.
Partial Hospitalization See details
UHC Medicare Advantage TC-0001 (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under the UHC Medicare Advantage TC-0001 (PPO) plan cover ground and air ambulance services with a $290.00 copay and no coinsurance, subject to prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
UHC Medicare Advantage TC-0001 (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $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 and telehealth services are covered by UHC Medicare Advantage TC-0001 (PPO) with no copay and no coinsurance, while specialist visits range from a $0 to $45 copay with no coinsurance. Physical, occupational, speech, and podiatry therapies require a $45 copay and no coinsurance, and mental health services have a $0 to $25 copay with no coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
UHC Medicare Advantage TC-0001 (PPO) offers partially covered preventive services with no copay and no coinsurance for covered benefits, including annual physicals, kidney disease education, select screenings, fitness benefits, and home safety devices. Sub-services not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, 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
Hearing services are partially covered by UHC Medicare Advantage TC-0001 (PPO), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a $199.00 to $1,249.00 copay and no coinsurance (excluding inner, outer, and over-the-ear types), while OTC hearing aids are available with a $199.00 to $829.00 copay and no coinsurance.
Vision Services See details
UHC Medicare Advantage TC-0001 (PPO) partially covers vision services with no deductible, no coinsurance, and no copay for annual routine eye exams and contact lenses. Eyewear benefits feature a combined $150 limit every two years with no coinsurance and copays of $0 to $153 for eyeglass lenses, while other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Medicare Advantage TC-0001 (PPO) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and preventive care like exams, cleanings, and x-rays with no copay and no coinsurance. However, comprehensive services such as restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Medicare Advantage TC-0001 (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including insulin, chemotherapy, and radiation, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by UHC Medicare Advantage TC-0001 (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Medicare Advantage TC-0001 (PPO) covers durable medical equipment, prosthetic devices, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 20% coinsurance with no copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
UHC Medicare Advantage TC-0001 (PPO) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. There is no copay for lab services and diagnostic radiology, but members pay a $30 copay for outpatient X-rays, a $50 copay for diagnostic procedures, and a minimum $60 copay for therapeutic radiology.
Home Health Services See details
Home health services are covered under the UHC Medicare Advantage TC-0001 (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Medicare Advantage TC-0001 (PPO) covers Cardiac Rehabilitation Services with no coinsurance and a required prior authorization, though in practice some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage TC-0001 (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Medicare Advantage TC-0001 (PPO) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
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