A non-government entity
UHC Care Advantage OR-E002 (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Care Advantage OR-E002 (HMO-POS I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Care Advantage OR-E002 (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
UHC Care Advantage OR-E002 (HMO-POS I-SNP) is a HMO-POS I-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Lane County. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Care Advantage OR-E002 (HMO-POS 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 Care Advantage OR-E002 (HMO-POS 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 Care Advantage OR-E002 (HMO-POS 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 Care Advantage OR-E002 (HMO-POS 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.
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 $195.00 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 $6000.00 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 Care Advantage OR-E002 (HMO-POS I-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 Care Advantage OR-E002 (HMO-POS I-SNP) plan has a $195 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. In the initial coverage phase, you will pay a copay for some drugs, and coinsurance for others. For example, you will pay a $12 copay for preferred generic drugs at a standard pharmacy. You will pay 30% coinsurance for non-preferred drugs. After your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for your drugs.
Additional Benefits
The UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan offers a variety of benefits with varying costs. Hospital stays have a $200 copay for the first seven days, and then no copay. Outpatient services, including doctor visits, have copays ranging from $0 to $175. Preventive services, primary care, hearing, vision, and dental services have no copay. The plan also includes coverage for ambulance and transportation services, emergency services, and home health services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $200 copay for days 1-7, and no copay for days 8-90, while Additional Days for Inpatient Hospital-Acute has no copay for days 91-999. For Inpatient Hospital Psychiatric, you will pay a $200 copay for days 1-7, and no copay for days 8-90. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $175, Observation Services with a $175 copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual Outpatient Substance Abuse sessions with a copay between $0 and $25, Group Outpatient Substance Abuse sessions with a $15 copay, and Outpatient Blood Services with no copay. All services require prior authorization.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan, and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a $100 copay, and transportation services to plan-approved health-related locations with no copay, up to 36 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by UHC Care Advantage OR-E002 (HMO-POS I-SNP). Emergency services have a $110 copay, while urgently needed services have a copay between $0 and $40, and worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation have no copay.
Primary Care See details
The UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, and additional telehealth benefits have no copay. The plan covers individual and group sessions for mental health and psychiatric services, with a copay between $0 and $25 for individual sessions and $15 for group sessions. Podiatry services and routine foot care have no copay. Other health care professional services have a copay between $0 and $25. Physical therapy and speech-language pathology services have a copay between $0 and $25. Opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. Additional preventive services are covered, and some services have a copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams, with no copay, and prescription hearing aids, with a maximum plan benefit of $2,200 per year, and OTC hearing aids with no copay. The plan does not cover fitting/evaluation for hearing aids, or prescription hearing aids for inner ear, outer ear, or over the ear.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams, including routine eye exams, have no copay. Eyewear, including contact lenses, eyeglass lenses, and eyeglass frames, have no copay, but eyeglass lenses, and eyeglass frames are limited to one pair per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan covers Medicare Dental Services with 20% coinsurance and other dental services with a $2,400 annual maximum, and oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery, with no copay. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment are covered. DME has a 20% coinsurance and requires authorization. Prosthetic Devices have a 0-20% coinsurance, while Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Therapeutic Radiological Services, are covered with a coinsurance of at most 20%, while Lab Services have no copay, and Outpatient X-Ray Services have no copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the UHC Care Advantage OR-E002 (HMO-POS I-SNP) plan 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 with prior authorization, but not in practice. The plan does not cover 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 Care Advantage OR-E002 (HMO-POS I-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with no copay, while acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management, Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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