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UHC One Care MA-Y4 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC One Care MA-Y4 (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-Y4 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC One Care MA-Y4 (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-Y4 (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-Y4 (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-Y4 (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-Y4 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.70. 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 One Care MA-Y4 (HMO D-SNP) Medicare Advantage plan features an annual prescription drug deductible of $615. This deductible represents the amount you must pay out-of-pocket for covered medications before the plan begins to pay its share. Specific drug coverage tier details, including individual copayments and coinsurance rates for different medication levels, are currently not available for this plan. To understand your exact costs for specific prescriptions, it is recommended to review the plan's formulary or contact the provider directly.
Additional Benefits
The UHC One Care MA-Y4 (HMO D-SNP) plan offers essential medical coverage, featuring no copays for primary care, specialist visits, home health services, and diagnostic radiology. However, inpatient hospital stays require a copay of $2,230 per stay for acute care and $2,080 for psychiatric care, while emergency room visits carry a $115 copay. Many other services, such as outpatient care, dialysis, and durable medical equipment, feature no copay but require a coinsurance ranging up to 20%. It is important to note that this plan has limited coverage for routine supplemental benefits. Routine dental, vision, and hearing services—including cleanings, eyeglasses, and hearing aids—are not covered, though diagnostic exams are available. Additionally, there is no coverage for fitness benefits, over-the-counter items, acupuncture, or meal benefits, and many covered services require prior authorization.
Inpatient Hospital See details
UHC One Care MA-Y4 (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC One Care MA-Y4 (HMO D-SNP) with no copays, though coinsurance ranges from 0% to 20% depending on the service. This coverage includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, all of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC One Care MA-Y4 (HMO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services under UHC One Care MA-Y4 (HMO D-SNP) include ground and air ambulance services with a 20% coinsurance and no copay, which require prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
UHC One Care MA-Y4 (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 a copay ranging from no copay to $40 and no coinsurance, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
UHC One Care MA-Y4 (HMO D-SNP) covers primary care, specialist, mental health, and psychiatric services with no copay and 0% to 20% coinsurance. Physical, occupational, and speech therapy are covered with no copay and 20% coinsurance, while telehealth and opioid treatment services feature no copay and no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC One Care MA-Y4 (HMO D-SNP), featuring no copay or coinsurance for Medicare-covered zero-dollar preventive services and kidney disease education, and no copay for diabetes self-management training. A 20% coinsurance applies to digital rectal exams and EKGs following a welcome visit, while annual physical exams and all listed additional preventive services—including fitness benefits and health education—are not covered.
Hearing Services See details
Hearing services under UHC One Care MA-Y4 (HMO D-SNP) are limited to diagnostic hearing exams, which are covered with no copay, no coinsurance, and no deductible, though prior authorization is required. Routine hearing exams, fitting and evaluation services, and all prescription and over-the-counter hearing aids are not covered.
Vision Services See details
Vision Services under UHC One Care MA-Y4 (HMO D-SNP) are covered with no copay and no coinsurance, but only some services are covered in practice as routine eye exams, contact lenses, and eyeglasses are not covered.
Dental Services See details
UHC One Care MA-Y4 (HMO D-SNP) provides partial dental coverage, with Medicare-covered dental services requiring no copay and a 20% coinsurance, subject to prior authorization. Other preventive, routine, and orthodontic dental services, such as oral exams, cleanings, x-rays, and reconstructive surgeries, are not covered.
Home Infusion bundled Services See details
UHC One Care MA-Y4 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, are covered with a coinsurance ranging from 0% to 20%, with insulin specifically featuring no copay.
Dialysis Services See details
Dialysis Services are covered under the UHC One Care MA-Y4 (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC One Care MA-Y4 (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for most of these medical equipment benefits.
Diagnostic and Radiological Services See details
UHC One Care MA-Y4 (HMO D-SNP) covers diagnostic and radiological services with prior authorization, featuring diagnostic radiological services with no copay and no coinsurance. Diagnostic procedures and tests require a copay and a minimum 20% coinsurance, while therapeutic radiology and outpatient X-rays require no copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the UHC One Care MA-Y4 (HMO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC One Care MA-Y4 (HMO D-SNP) with no copay and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC One Care MA-Y4 (HMO D-SNP) with no coinsurance, standard Medicare-defined copayments, and required prior authorization. This benefit does not require a prior three-day inpatient hospital stay, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the UHC One Care MA-Y4 (HMO D-SNP) plan, which means there is no coverage or cost-sharing benefit for acupuncture, over-the-counter (OTC) items, or meal benefits.
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