A non-government entity
UHC Nursing Home Plan NC-F002 (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 NC-F002 (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 NC-F002 (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan NC-F002 (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 North Carolina. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Nursing Home Plan NC-F002 (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 NC-F002 (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 NC-F002 (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 NC-F002 (HMO-POS I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.70. 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 $7000.00 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 Nursing Home Plan NC-F002 (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 Nursing Home Plan NC-F002 (HMO-POS I-SNP) has a $590 deductible for prescription drugs. After the deductible is met, you will pay the cost-sharing amounts for each drug tier. The plan also has a Part D premium of $51.20 for those who qualify for the low-income subsidy.
Additional Benefits
The UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) provides coverage for a range of services with varying cost-sharing. This plan includes inpatient hospital stays with a $2,000 copay, outpatient services with coinsurance, and emergency services with a $110 copay. Preventive services, primary care, and home health services are covered with no copay, while hearing, vision, and dental services offer additional benefits like hearing aids, eyewear, and dental care with no copay for many services. The plan also covers ambulance services, transportation, and medical equipment, but cardiac rehabilitation services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a $2,000 copay for a Medicare-covered stay. Additional days, non-Medicare stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a coinsurance between 0% and 10%, observation services with a 10% coinsurance, and ambulatory surgical center (ASC) services with a coinsurance between 0% and 10%. Outpatient substance abuse services are covered with a coinsurance between 0% and 20% for individual and group sessions. Outpatient blood services are also covered with a coinsurance between 0% and 20%.
Partial Hospitalization See details
Partial Hospitalization is covered, with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
The UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) covers ambulance services with a 20% coinsurance for both ground and air ambulance services, and transportation services to a plan-approved health-related location with no copay for up to 18 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) with a $110 copay, and there is no coinsurance. Urgently Needed Services are covered with a copay between $0 and $40, 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 NC-F002 (HMO-POS I-SNP) plan covers primary care physician services with no copay and covers chiropractic services with a coinsurance of 0% - 20%, but routine chiropractic care is not covered. Occupational therapy services and physical therapy services are covered with no coinsurance. Specialist and mental health services are covered with a coinsurance of 0% - 20%. Podiatry services are covered with a coinsurance of 0% - 20% and no copay, with routine foot care being covered. Other health care professional and opioid treatment program services are covered with no copay. Additional telehealth benefits are covered with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar services, annual physical exams with no copay, and additional preventive services. Additional services include coverage for Glaucoma Screening with 0-20% coinsurance, Diabetes Self-Management Training with no copay, Barium Enemas with no copay, Digital Rectal Exams with 0-20% coinsurance, and EKG following Welcome Visit with 0-20% coinsurance; however, Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, 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 hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no coinsurance and are covered for 1 visit per year, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered for up to $2200 per year, and OTC hearing aids have no copay.
Vision Services See details
The UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) plan covers vision services, including routine eye exams with no copay and a coinsurance between 0% and 20%, and eyewear with a combined maximum benefit of $300 per year. Contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, while eyeglasses and upgrades are not covered.
Dental Services See details
The UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) plan covers dental services, with no copay for 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. There is no coinsurance for Medicare Dental Services, but prior authorization is required, and a coinsurance may apply for some services. Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and between 0% and 20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with between 0% and 20% coinsurance, and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP), but require prior authorization. The coinsurance ranges from 0% to 20%.
Medical Equipment See details
Medical Equipment is covered by the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Medicare-covered Prosthetic Devices have a 0-20% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic and radiological services, are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of up to 20%, while Therapeutic Radiological Services have a 20% coinsurance. Lab Services and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) 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 not covered by the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP). Specifically, 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 are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Nursing Home Plan NC-F002 (HMO-POS I-SNP) with prior authorization. For days 1-100, there is no copay, and there is no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include 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