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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 2025, 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 2025.
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 $43.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $68.00. 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 Maximum Out-Of-Pocket cost of $5000.00 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) has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2,000. If you qualify for the low-income subsidy, you will pay $43.50. Once your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) offers a variety of benefits with varying cost-sharing. Inpatient hospital stays have a $2,000 copay, while outpatient services often involve coinsurance between 0% and 20%. Many services, such as primary care, preventive services like annual physical exams, hearing exams, and dental services like oral exams, have no copay. The plan covers ambulance and transportation services with a 20% coinsurance, and emergency services have a $90 copay. Home health services and skilled nursing facilities (days 1-100) have no copay. The plan also offers no copay for OTC items, and many vision services such as eye exams and eyewear.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, each with a $2,000 copay for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for Inpatient Hospital-Acute and Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a coinsurance of 0% - 20%, observation services with a 20% coinsurance, and ambulatory surgical center (ASC) services with a coinsurance between 0% and 20%. Outpatient substance abuse services, including individual and group sessions, are covered with a coinsurance between 0% and 20%, and outpatient blood services are covered with a coinsurance of 0% - 20%.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP), including ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered, with no copay, up to 60 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services are covered under the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP), with a $90 copay and no coinsurance. Urgently Needed Services are covered with a copay between $0 and $10, and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) plan covers primary care physician services, and physical therapy and speech-language pathology services with no copay, as well as individual and group sessions for mental health specialty services and psychiatric services with 0-20% coinsurance. Chiropractic services, physician specialist services, and other health care professionals are covered with 0-20% coinsurance, and podiatry services are covered with 0-20% coinsurance for routine foot care. Additional Telehealth benefits and Opioid Treatment Program Services are covered with no copay. Routine chiropractic care is not covered.
Preventive Services See details
The UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services such as glaucoma screenings, diabetes self-management training, and barium enemas have no copay, while digital rectal exams and EKG following a welcome visit have a 20% maximum coinsurance. Some preventive services like health education, and counseling are not covered.
Hearing Services See details
Hearing Services are covered, including hearing exams and prescription and OTC hearing aids. Hearing exams have a coinsurance of at most 20% for routine hearing exams, with no copay or deductible, and prescription hearing aids have no copay. OTC hearing aids have no copay.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a coinsurance of 0% to 20% for routine eye exams, with no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 0% - 20% coinsurance, and other services like oral exams, dental x-rays, and other diagnostic services with no copay. Restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics fixed, and oral and maxillofacial surgery are covered with no copay; however, Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) and require prior authorization. You will pay between 0% and 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, and 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 Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
The UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) covers Diagnostic and Radiological Services, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of up to 20%, Therapeutic Radiological Services with a 20% coinsurance, and Outpatient X-Ray Services with no copay. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan WI-F001 (HMO-POS I-SNP) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but there is no specific information on the cost sharing for these services, and prior authorization is required. However, the plan does not cover any of the sub-services, including 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 with a prior authorization requirement, and there is no copay for days 1-100. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, 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.
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