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UHC Senior Care Options NHC MA-Y002 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Senior Care Options NHC MA-Y002 (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 NHC MA-Y002 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC Senior Care Options NHC MA-Y002 (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 NHC MA-Y002 (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 NHC MA-Y002 (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 NHC MA-Y002 (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 NHC MA-Y002 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.80. 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:
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Drug Coverage
The UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for your covered medications before the plan begins to pay its share. Specific drug tier details, including individual copayments and coinsurance amounts, are currently unavailable for this plan. To find the exact costs for your specific prescription drugs under this plan, it is recommended to consult the plan's comprehensive formulary list.
Additional Benefits
The UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) offers comprehensive medical coverage with many services featuring no copays, though coinsurance and prior authorizations frequently apply. Inpatient hospital stays require a $1,820 copay per admission with no coinsurance, while skilled nursing facility stays and home health services are covered with no copay and no coinsurance. Primary care, specialist visits, and outpatient hospital services generally feature no copays but carry a coinsurance ranging from 0% to 20%. Emergency services require a $115 copay that is waived if you are admitted, while unlimited transportation to plan-approved locations is available with no copay or coinsurance. Most preventive dental care and over-the-counter items are covered with no copay and no coinsurance, though medical equipment, dialysis, and Medicare-covered dental services require a 20% coinsurance. Routine vision exams, hearing aids, and podiatry services are not covered under this plan.
Inpatient Hospital See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,820 copayment per admission and no coinsurance, requiring prior authorization. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are provided with no copay.
Outpatient Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers outpatient services with no copays, though coinsurance ranging from 0% to 20% applies to outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services are also covered with no copay and a 20% coinsurance, and prior authorization is required for most outpatient benefits.
Partial Hospitalization See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering unlimited rides to plan-approved locations via taxi or medical transport with no copay or coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers emergency services with a $115 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $0 to $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) are covered with no copay and 0% to 20% coinsurance for primary care, specialist, and mental health services. Physical, occupational, and speech therapies require no copay and 20% coinsurance, while telehealth and opioid treatment have no copay and no coinsurance. Podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive Services are partially covered by UHC Senior Care Options NHC MA-Y002 (HMO D-SNP), offering no copay and no coinsurance for annual physical exams, kidney disease education, and fitness benefits, while digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance. Several additional supplemental benefits are not covered, including health education, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing services are covered by UHC Senior Care Options NHC MA-Y002 (HMO D-SNP), providing one routine hearing exam annually with no copay, a 20% coinsurance, and no deductible under prior authorization. Although some services are covered, fitting evaluations, OTC hearing aids, and all types of prescription hearing aids (including inner ear, outer ear, and over the ear) are not covered.
Vision Services See details
Vision Services are covered under UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) with no copay and no coinsurance. However, in practice only some services are covered, as routine eye exams, other eye exams, contact lenses, eyeglasses, and upgrades are not covered.
Dental Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) offers partially covered dental services, featuring no copay and 20% coinsurance for Medicare-covered dental services, and no copay and no coinsurance for most preventive and comprehensive dental benefits. Maxillofacial prosthetics, implant services, and orthodontics are not covered by this plan.
Home Infusion bundled Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers Home Infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, feature a coinsurance ranging from 0% to 20% and no copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Senior Care Options NHC MA-Y002 (HMO D-SNP), with prior authorization required for all services. Diagnostic radiological services feature no copay and no coinsurance, while lab services require no copay, and outpatient X-rays, therapeutic radiology, and diagnostic tests carry a 20% coinsurance, with diagnostic tests also requiring a copay.
Home Health Services See details
Home Health Services are covered by UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay and prior authorization required, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Senior Care Options NHC MA-Y002 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. This benefit is partially covered because additional days beyond the standard Medicare-covered limit are not covered, and prior authorization is required.
Other Services See details
Other services are partially covered by UHC Senior Care Options NHC MA-Y002 (HMO D-SNP), which offers over-the-counter (OTC) items with no copay and no coinsurance, but does not cover acupuncture or meal benefits. Covered OTC items include nicotine replacement therapy and naloxone with no maximum plan benefit limit.
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