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UHC Nursing Home Plan OH-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 OH-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 OH-F002 (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan OH-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 Clark, Lake and Lucas Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Nursing Home Plan OH-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 OH-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 OH-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 OH-F002 (HMO-POS I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.30. 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 $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 $8000.00 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 OH-F002 (HMO-POS I-SNP) has a $590 deductible for prescription drugs. After you meet the deductible, you will pay the costs for each drug tier. The plan's premium may be reduced if you qualify for the low-income subsidy, and the premium is $39.30 with LIS.
Additional Benefits
The UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $2,000 copay, while outpatient services have coinsurance between 0% and 20%. Many services, like primary care visits, dental, vision, and home health services, have no copay. The plan also covers ambulance services with 20% coinsurance and transportation to health-related locations with no copay for up to 12 trips per year. Emergency services have a $110 copay, and preventive services have no copay, with some services having up to 20% coinsurance. Additionally, the plan offers benefits such as partial hospitalization with no copay, and skilled nursing with no copay for days 1-100.
Inpatient Hospital See details
Inpatient Hospital benefits, including both acute and psychiatric care, are covered under the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) with a $2,000 copay for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a coinsurance of 0% - 10%, Observation Services have a 10% coinsurance, and Outpatient Blood Services have a coinsurance of 0% - 20%. Individual and group sessions for outpatient substance abuse have a coinsurance of 0% - 20%, while ambulatory surgical center (ASC) services have a coinsurance of 0% - 10%.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP), with a $0 copay, and no coinsurance. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location are covered with no copay, up to 12 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services are covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP), with a $110 copay and no coinsurance. Urgently Needed Services are covered with a copay between $0 and $40, and no coinsurance, while Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are not covered.
Primary Care See details
The UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) plan covers primary care physician services with no copay. Chiropractic services are covered with 0-20% coinsurance. Occupational therapy services, physician specialist services, and other health care professional visits have no copay. Mental health and psychiatric individual and group sessions have 0-20% coinsurance. Podiatry services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services have no copay.
Preventive Services See details
The UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) plan covers preventive services including an annual physical exam with no copay. Additional preventive services, including Medicare-covered Glaucoma Screening, may have a coinsurance of up to 20%, while Barium Enemas and Digital Rectal Exams may have a copay.
Hearing Services See details
Hearing Services are partially covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP), including hearing exams with a coinsurance of at most 20%, but routine hearing exams and fitting/evaluation for hearing aids are not covered. Prescription hearing aids and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Routine eye exams have no copay, and are limited to one per year, and have 0% to 20% coinsurance. Contact lenses and eyeglass lenses have no copay, and are limited to one per year. Eyeglass frames have no copay and are limited to one per year. Eyewear, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services include coverage 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 and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery with no copay; however, there is a 0% to 20% coinsurance for Medicare dental services. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance is between 0% and 20%, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) and require prior authorization. There is no copay, and coinsurance ranges from 0% to 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered under the plan. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not 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 are covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP), with prior authorization required. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, and 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 OH-F002 (HMO-POS I-SNP) with no copay and no coinsurance, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but no specific services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) with prior authorization, with no copay for days 1-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services offered by the UHC Nursing Home Plan OH-F002 (HMO-POS I-SNP) include 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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