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UHC Nursing Home Plan OR-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 OR-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 OR-F002 (PPO I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan OR-F002 (PPO I-SNP) is a PPO I-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Lane and Multnomah Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Nursing Home Plan OR-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 OR-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 OR-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 OR-F002 (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $85.00. 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 $590.00 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 $9600.00 (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 $9600.00 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 OR-F002 (PPO I-SNP) has a $590 deductible for prescription drugs. Once the deductible is met, you pay the costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan OR-F002 (PPO I-SNP) offers coverage for a wide range of services, including inpatient and outpatient care, with varying cost-sharing. Many services, such as primary care, home health, and routine eye exams, have no copay, while others, like inpatient hospital stays, have a copay of $2,000. This plan also provides coverage for hearing and vision services, with hearing aids covered up to a yearly maximum, and dental services. Additionally, it includes benefits like ambulance services, medical equipment, and home infusion, with specific cost-sharing arrangements like coinsurance percentages.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a copay of $2,000 for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for both are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a coinsurance between 0% and 10%, Observation Services have a 10% coinsurance, Ambulatory Surgical Center (ASC) Services have a coinsurance between 0% and 10%, Individual and Group Sessions for Outpatient Substance Abuse have a coinsurance between 0% and 20%, and Outpatient Blood Services have a coinsurance between 0% and 20%.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Nursing Home Plan OR-F002 (PPO I-SNP) with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay and are limited to 60 one-way trips per year.
Emergency Services See details
Emergency Services are covered under the UHC Nursing Home Plan OR-F002 (PPO I-SNP), with a copay of $110.00, and no coinsurance. Urgently Needed Services are also covered with a copay between $0.00 and $40.00, and no coinsurance. Worldwide Emergency Services are not covered.
Primary Care See details
The UHC Nursing Home Plan OR-F002 (PPO I-SNP) covers primary care physician services with no copay, and also covers chiropractic services with a coinsurance of 0% to 20%. Occupational therapy services are covered with no coinsurance and no copay. Physician specialist services and mental health specialty services are covered with a coinsurance of 0% to 20%. Podiatry services are covered with a coinsurance of 0% to 20% and no copay. Other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services are covered with no copay.
Preventive Services See details
The UHC Nursing Home Plan OR-F002 (PPO I-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services include glaucoma screening (0-20% coinsurance), diabetes self-management training (no copay), barium enemas (no copay), digital rectal exams (0-20% coinsurance), and EKG following a Welcome Visit (0-20% coinsurance). Some preventive services like health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams and prescription and OTC hearing aids. Routine hearing exams have no copay and at most 20% coinsurance, with a limit of one exam per year, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a plan maximum of $3200 every year for both in-network and out-of-network services, and OTC hearing aids have no copay, with a limit of 2 hearing aids every year.
Vision Services See details
Vision services include eye exams and eyewear. Routine eye exams have no copay and a coinsurance of 0%, while other eye exams have a coinsurance of 0-20%. Eyewear coverage includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, though eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Nursing Home Plan OR-F002 (PPO I-SNP) plan covers a variety of dental services. Medicare Dental Services have a coinsurance of 0% to 20%, while other services such as oral exams, dental x-rays, and other diagnostic and preventative services have no copay. Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay, and other Medicare Part B drugs and Medicare Part B chemotherapy/radiation drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan OR-F002 (PPO I-SNP), but require prior authorization. You will pay between 0% and 20% coinsurance.
Medical Equipment See details
Medical equipment benefits are covered, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Durable Medical Equipment has a 20% coinsurance and requires authorization, while durable medical equipment for use outside the home is not covered. Prosthetic Devices have a 0-20% coinsurance, while medical supplies have a 20% coinsurance. Diabetic Supplies and Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests and Diagnostic Radiological Services, have a coinsurance of up to 20%, while Lab Services and Outpatient X-Ray Services have no copay. Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the UHC Nursing Home Plan OR-F002 (PPO I-SNP) with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but all sub-services are not covered. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan OR-F002 (PPO I-SNP) with no copay for days 1-100, but additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required for this benefit.
Other Services See details
The UHC Nursing Home Plan OR-F002 (PPO I-SNP) plan covers over-the-counter items with no copay, but acupuncture, meal benefits, and several other services are not covered. This plan also offers nicotine replacement therapy and naloxone coverage as a Part C OTC benefit.
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