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UHC One Care MA-Y3 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC One Care MA-Y3 (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 One Care MA-Y3 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC One Care MA-Y3 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Select Counties of Massachusetts. The overall rating for this plan is not yet available for 2026.
It's important to know that UHC One Care MA-Y3 (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 One Care MA-Y3 (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 One Care MA-Y3 (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 One Care MA-Y3 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $534.00 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 One Care MA-Y3 (HMO D-SNP) plan features an annual prescription drug deductible of $534. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy the benefit of no copay for standard pharmacy fills of 1-month and 3-month supplies. This $0 cost-sharing also applies to 3-month standard mail order deliveries for these generic tiers. For brand-name and specialty medications, the plan transitions to a percentage-based cost-sharing model. Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail order fills. This structure offers predictable savings on generics while sharing costs on higher-tier prescriptions.
Additional Benefits
The UHC One Care MA-Y3 (HMO D-SNP) plan offers comprehensive coverage for essential medical needs, featuring no copays for primary care, outpatient services, and home health care, though coinsurance of up to 20% may apply. Inpatient hospital stays require a copayment of $2,135 for acute care and $2,080 for psychiatric care, both with no coinsurance. Emergency room visits carry a $115 copay, which is waived if you are admitted, while Medicare-covered preventive services are available with no copays or coinsurance. For specialized care, skilled nursing facilities and diagnostic hearing exams are covered with no copays or coinsurance, while durable medical equipment and dialysis services require a 20% coinsurance. It is important to note that this plan does not cover routine dental, vision, or hearing services, nor does it provide coverage for transportation, over-the-counter items, or acupuncture. Prior authorization is required for several covered benefits, including inpatient stays, outpatient services, and home health care.
Inpatient Hospital See details
Inpatient Hospital care is partially covered by the UHC One Care MA-Y3 (HMO D-SNP) plan, featuring a $2,135 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, with no coinsurance required for either. Prior authorization is required, and the plan does not cover additional days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Outpatient services are covered by UHC One Care MA-Y3 (HMO D-SNP) with no copays, though prior authorization is required and coinsurance ranges from no coinsurance to 20%. Covered care includes outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services.
Partial Hospitalization See details
UHC One Care MA-Y3 (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
UHC One Care MA-Y3 (HMO D-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 coinsurance and a copay ranging from no copay to $40, but while some worldwide emergency services are covered, worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Primary care benefits under UHC One Care MA-Y3 (HMO D-SNP) feature no copays and coinsurance ranging from 0% to 20% for primary care, specialists, and mental health services. Telehealth and opioid treatments are fully covered with no copays and no coinsurance, while podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic care are not covered.
Preventive Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers preventive services with no copay or coinsurance for Medicare-covered preventive care, kidney disease education, glaucoma screenings, and diabetes self-management training. This benefit is partially covered, as annual physical exams and additional services like fitness benefits are not covered, and a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs.
Hearing Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers diagnostic hearing exams with no copay, no coinsurance, and no deductible, though prior authorization is required. Routine hearing exams, fitting evaluations, and all types of prescription and OTC hearing aids are not covered under this plan.
Vision Services See details
Vision services are not covered under the UHC One Care MA-Y3 (HMO D-SNP) plan, as routine eye exams, contact lenses, and eyeglasses are all excluded from coverage.
Dental Services See details
UHC One Care MA-Y3 (HMO D-SNP) partially covers dental services, offering Medicare-covered dental services with no copay and a 20% coinsurance, which require prior authorization. Other dental services, including routine preventive care like exams and cleanings, as well as comprehensive services like orthodontics, restorative, and periodontics, are not covered.
Home Infusion bundled Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers Home Infusion bundled Services with no copay, subject to prior authorization. Under this benefit, Medicare Part B drugs—including insulin, chemotherapy, and radiation drugs—require no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by UHC One Care MA-Y3 (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment benefits under UHC One Care MA-Y3 (HMO D-SNP) are covered, requiring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay from specified manufacturers, while diabetic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC One Care MA-Y3 (HMO D-SNP) with prior authorization, featuring no copay for lab services and a copay with a minimum 20% coinsurance for diagnostic tests. Radiological services have no copay, offering no coinsurance for diagnostic radiology and a minimum 20% coinsurance for therapeutic and outpatient X-ray services.
Home Health Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC One Care MA-Y3 (HMO D-SNP) covers some Cardiac Rehabilitation Services with no copay, though prior authorization is required. However, key sub-services including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC One Care MA-Y3 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because additional days beyond the Medicare-covered limit are not covered, but the plan does allow admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services are not covered under the UHC One Care MA-Y3 (HMO D-SNP) plan, meaning there is no coverage, copay, or coinsurance for acupuncture, over-the-counter (OTC) items, and meal benefits.
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