A non-government entity
UHC Senior Care Options MA-Y001 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Senior Care Options MA-Y001 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Senior Care Options MA-Y001 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC Senior Care Options MA-Y001 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Massachusetts. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Senior Care Options MA-Y001 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Senior Care Options MA-Y001 (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Senior Care Options MA-Y001 (HMO D-SNP).
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 Senior Care Options MA-Y001 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $14.50. 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 $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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Sign up for UHC Senior Care Options MA-Y001 (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Senior Care Options MA-Y001 (HMO D-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered prescription drugs before the plan begins to cover its share of the costs. Knowing this deductible amount is crucial for evaluating your potential yearly healthcare expenses under this plan. Detailed information regarding specific drug tiers, copays, and coinsurance is not currently available for this plan. To fully understand your out-of-pocket costs, you should check the plan's formulary to see how your specific medications are covered. This will help you determine if this UnitedHealthcare Senior Care Options plan is the right fit for your prescription drug needs.
Additional Benefits
The UHC Senior Care Options MA-Y001 (HMO D-SNP) offers robust coverage for essential medical services, featuring inpatient hospital stays with a $1,995 copay per admission and no coinsurance. Primary care, specialist, telehealth, and mental health visits require no copay, with coinsurance ranging up to 20%. Outpatient services also feature no copays, while emergency care has a $115 copay that is waived upon hospital admission. Preventive care, routine dental cleanings, home health services, and skilled nursing facility stays are available with no copay and no coinsurance. However, vision services and hearing aids are not covered under this plan, and routine hearing exams require a 20% coinsurance. Other benefits like medical equipment, dialysis, and ambulance services also have no copay but require a 20% coinsurance.
Inpatient Hospital See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,995 copay per admission and no coinsurance. The benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute hospital days are available with no copay.
Outpatient Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers outpatient services with no copays, though coinsurance ranges from 0% to 20% and prior authorization is required. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse treatment, and outpatient blood services with no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Senior Care Options MA-Y001 (HMO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Although transportation services are technically covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers emergency services with a $115 copay—waived if admitted to the hospital within 24 hours—and no coinsurance. Urgently needed services have a copay ranging from no copay up 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 Senior Care Options MA-Y001 (HMO D-SNP) covers primary care, specialist, telehealth, and mental health services with no copays and coinsurance ranging from no coinsurance to 20%. Therapy services are covered with no copays and 20% coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, glaucoma screenings, diabetes training, fitness benefits, and caregiver support. While digital rectal exams and post-welcome visit EKGs require a 20% coinsurance with no copay, other sub-services—including health education, PERS, medical nutrition therapy, alternative therapies, therapeutic massage, and adult day health—are not covered.
Hearing Services See details
Hearing services covered by UHC Senior Care Options MA-Y001 (HMO D-SNP) include one routine hearing exam per year with no copay and a 20% coinsurance, subject to prior authorization. Fitting and evaluation services, prescription hearing aids, and OTC hearing aids are not covered under this plan.
Vision Services See details
Vision services are not covered under the UHC Senior Care Options MA-Y001 (HMO D-SNP) plan, as all sub-services for eye exams and eyewear are excluded from coverage.
Dental Services See details
Dental services are partially covered under the UHC Senior Care Options MA-Y001 (HMO D-SNP) plan, with Medicare-covered dental services requiring no copay and a 20% coinsurance. Preventive and other covered comprehensive services, including oral exams, cleanings, and restorative services, feature no copay and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, have no copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers medical equipment with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay but are limited to specified manufacturers, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers diagnostic and radiological services with prior authorization, featuring a copay and 20% minimum coinsurance for diagnostic procedures and no copay for lab services. Radiological services require no copays, offering no coinsurance for diagnostic radiology and a 20% minimum coinsurance for therapeutic and outpatient X-ray services.
Home Health Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Senior Care Options MA-Y001 (HMO D-SNP) with no copay, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required and additional days beyond Medicare-covered days are not covered. Admission to a participating facility is allowed without a prior three-day inpatient hospital stay.
Other Services See details
UHC Senior Care Options MA-Y001 (HMO D-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered. Covered OTC items include nicotine replacement therapy and naloxone, which are eligible for reimbursement with no maximum coverage limit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved