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UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Nursing Home Plan WI-F001 (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 Nursing Home Plan WI-F001 (HMO-POS I-SNP) in 2026, please refer to our full plan details page.
UHC Nursing Home Plan WI-F001 (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 Select Counties in Wisconsin. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Nursing Home Plan WI-F001 (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 Nursing Home Plan WI-F001 (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 Nursing Home Plan WI-F001 (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 Nursing Home Plan WI-F001 (HMO-POS I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $7.70. 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 Nursing Home Plan WI-F001 (HMO-POS I-SNP) prescription drug coverage includes an annual drug deductible of $615. You must pay this deductible amount out-of-pocket for your medications before the plan's coverage begins to pay. While specific drug tier details regarding copays and coinsurance are not currently available, knowing the deductible helps you estimate your initial yearly healthcare costs. For complete details on specific medication coverage and tiers, you should consult the plan's comprehensive formulary.
Additional Benefits
The UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) offers comprehensive medical coverage with structured cost-sharing. While inpatient hospital stays require a copayment of $2,095 for acute care or $2,080 for psychiatric care, many other services like primary care, specialists, and outpatient care feature no copay and coinsurance ranging from 0% to 20%. Additionally, emergency room visits have a $115 copay that is waived if admitted, and urgent care ranges from no copay to a $40 copay. This plan also provides excellent coverage for routine and supplemental care to help manage your health expenses. Preventive dental services, home health care, skilled nursing facility stays up to 100 days, and over-the-counter items are fully covered with no copay and no coinsurance. Routine vision and hearing benefits also feature no copays, offering up to a $300 annual eyewear allowance and a $2,200 hearing aid limit every two years with no coinsurance.
Inpatient Hospital See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,095 copayment per acute care stay and a $2,080 copayment per psychiatric stay. Prior authorization is required for these covered stays, while additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copays, though prior authorization is required and coinsurance ranges from no coinsurance up to 20%. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse treatment, and blood services, all of which require no copay and carry a maximum coinsurance of 20%.
Partial Hospitalization See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers partial hospitalization services with no copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, but trips to any health-related location are not covered.
Emergency Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers emergency services with a $115 copay (waived if admitted within 24 hours) and no coinsurance, alongside urgently needed services with a copay of no copay to $40 and no coinsurance. Some worldwide emergency services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers primary care, specialist, and therapy services with no copay and coinsurance ranging from 0% to 20%, though chiropractic benefits are only partially covered since routine and other chiropractic services are not covered. Telehealth and opioid treatment services are also covered with no copay and no coinsurance.
Preventive Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers preventive services, offering annual physical exams, kidney disease education, and home safety modifications with no copay or coinsurance. Some specific services, such as glaucoma screenings and post-welcome visit EKGs, require a 20% coinsurance, while supplemental benefits like fitness programs, health education, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP), offering routine hearing exams with a 20% coinsurance and no copay, but excluding fitting and evaluation exams. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to a $2,200 limit every two years, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers vision services with no deductible, including one annual routine eye exam with no copay and a 20% coinsurance, though other eye exam services are not covered. Covered eyewear options like contact lenses, one pair of lenses, and one frame per year feature no copay and no coinsurance up to a $300 annual maximum, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) partially covers dental services, featuring Medicare-covered dental care with no copay and a 20% coinsurance. Preventive dental care—such as exams, cleanings, fluoride, and x-rays—is available with no copay and no coinsurance, though restorative, orthodontic, endodontic, periodontic, prosthodontic, implant, oral surgery, and other diagnostic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% (no coinsurance) to 20% coinsurance, while Part B insulin has a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers medical equipment, including durable medical equipment, medical supplies, prosthetics, and diabetic equipment, with no copay and prior authorization required. Beneficiaries pay a 20% coinsurance for most equipment and supplies, while prosthetic devices require between no coinsurance and 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers diagnostic and radiological services with prior authorization. Diagnostic procedures require a copay and minimum 20% coinsurance, while diagnostic radiological services require a copay with no coinsurance. Lab and therapeutic radiological services have no copay but require coinsurance, and outpatient X-rays are covered with no copay.
Home Health Services See details
Home Health Services are covered under the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) where some services are covered with no copay, subject to prior authorization. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) partially covers Skilled Nursing Facility (SNF) services, offering coverage for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. Additional days beyond the standard Medicare-covered limit are not covered under this plan.
Other Services See details
Other services are partially covered by UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP), which provides over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this benefit.
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