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UHC Nursing Home Plan NY-F002 (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Nursing Home Plan NY-F002 (PPO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Nursing Home Plan NY-F002 (PPO I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan NY-F002 (PPO I-SNP) is a PPO I-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New York. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Nursing Home Plan NY-F002 (PPO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Nursing Home Plan NY-F002 (PPO I-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 Nursing Home Plan NY-F002 (PPO I-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 Nursing Home Plan NY-F002 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.40. 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 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 Nursing Home Plan NY-F002 (PPO I-SNP) 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. Detailed information regarding specific drug tiers, copays, or coinsurance rates is currently unavailable for this plan. To determine how your specific medications are covered and what your final costs will be, you should consult the plan's formulary.
Additional Benefits
The UHC Nursing Home Plan NY-F002 (PPO I-SNP) offers comprehensive medical coverage with many services featuring no copayments, though coinsurance and prior authorizations apply to several benefits. Inpatient hospital stays require a set copay of either $2,230 for acute care or $2,080 for psychiatric care per stay, while outpatient services, primary care, and specialist visits generally feature no copay and coinsurance ranging from 0% to 20%. Additionally, emergency care has a $115 copay, which is waived upon hospital admission, and skilled nursing facility stays for days 1 through 100 are covered with no copay and no coinsurance. This plan also includes valuable supplemental benefits such as dental, vision, and hearing coverage, which largely eliminate copays up to specific annual limits. Dental services are covered with no copay and no coinsurance up to a $2,000 annual maximum, while eligible hearing aids are covered with no copay up to $2,200 every two years. Members also benefit from no copay for over-the-counter items, home health services, and up to 18 one-way plan-approved transportation trips per year.
Inpatient Hospital See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a copayment of $2,230 for acute care and $2,080 for psychiatric care per Medicare-covered stay. Additional days, upgrades, and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by the UHC Nursing Home Plan NY-F002 (PPO I-SNP) with no copays, though prior authorization is required. Outpatient hospital, ambulatory surgical, and substance abuse services feature no copays and coinsurance ranging from no coinsurance to 20%, while outpatient blood services have no copay, a 20% coinsurance, and no deductible.
Partial Hospitalization See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) partially covers ambulance and transportation services, providing ground and air ambulance coverage with a 20% coinsurance and no copay. Plan-approved transportation is covered with no copay and no coinsurance for up to 18 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) 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 no copay to a $40 copay and no coinsurance, but worldwide emergency, urgent, and transportation services are not covered in practice.
Primary Care See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers primary care, specialist, mental health, and therapy services with no copay and coinsurance ranging from 0% to 20%. For chiropractic services, some services are covered but routine chiropractic care and other chiropractic services are not covered, while telehealth and opioid treatment are available with no copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered by the UHC Nursing Home Plan NY-F002 (PPO I-SNP), which offers annual physicals, kidney disease education, and home safety modifications with no copay and no coinsurance. Glaucoma screenings and EKGs require a 20% coinsurance and no copay, while other services—including fitness benefits, health education, and personal emergency response systems—are not covered.
Hearing Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) offers partially covered hearing services, excluding hearing aid fittings and evaluations, as well as inner ear, outer ear, and over-the-ear prescription hearing aids. Covered routine hearing exams require a 20% coinsurance and no copay, while eligible OTC and prescription hearing aids are covered with no copay and no coinsurance up to a $2,200 maximum limit every two years.
Vision Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) offers partially covered vision services, featuring one annual routine eye exam with no copay and 20% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $200 annual limit for contact lenses, eyeglass lenses, and frames, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Nursing Home Plan NY-F002 (PPO I-SNP), offering preventive and comprehensive care with no copay and no coinsurance up to a $2,000 annual maximum, though orthodontics is not covered. Medicare-covered dental services are available with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan NY-F002 (PPO I-SNP) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Nursing Home Plan NY-F002 (PPO I-SNP) with no copays, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic equipment require a 20% coinsurance, while prosthetic devices range from no coinsurance up to 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers diagnostic and radiological services, with prior authorization required. Diagnostic tests require a copay and 20% coinsurance, lab services have no copay, and radiological services feature no copay, with no coinsurance for diagnostic radiology and 20% coinsurance for therapeutic radiology and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan NY-F002 (PPO I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers Cardiac Rehabilitation Services with no copay, though in practice only some services are covered. Specific services, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation, are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan NY-F002 (PPO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, without requiring a prior three-day inpatient hospital stay. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Nursing Home Plan NY-F002 (PPO I-SNP), which offers over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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