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UHC Care Advantage WI-E001 (HMO-POS I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Care Advantage WI-E001 (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 Care Advantage WI-E001 (HMO-POS I-SNP) in 2026, please refer to our full plan details page.
UHC Care Advantage WI-E001 (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 Care Advantage WI-E001 (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 Care Advantage WI-E001 (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 Care Advantage WI-E001 (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 Care Advantage WI-E001 (HMO-POS I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.10. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 $270.00 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 $4000.00 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 Care Advantage WI-E001 (HMO-POS I-SNP) prescription drug plan features an annual drug deductible of $270. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies or through mail order. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, though you can save with no copay for a 3-month supply when using preferred mail order. For brand-name and specialty medications, the plan transitions to a coinsurance structure. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs have a 50% coinsurance for a 1-month supply. Tier 5 specialty drugs are covered with a 30% coinsurance for a 1-month supply across standard pharmacies and mail-order options.
Additional Benefits
The UHC Care Advantage WI-E001 (HMO-POS I-SNP) offers comprehensive medical coverage with no copay and no coinsurance for primary care, telehealth, home health services, and preventive care. For inpatient hospital stays, members pay a $350 daily copay for days one through seven and no copay thereafter, while skilled nursing facility stays are fully covered with no copay for up to 100 days. Outpatient hospital services and specialist visits are also highly accessible, featuring no coinsurance and minimal to no copays. Supplemental benefits include dental, vision, and hearing coverage with no copay, featuring a $2,200 hearing aid allowance and a $300 annual eyewear allowance. Members also receive up to 36 one-way transportation trips per year and over-the-counter items with no copay. Emergency care is available with a $150 copay, while durable medical equipment and dialysis services generally require no copay and a twenty percent coinsurance.
Inpatient Hospital See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 7 and no copay for days 8 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) with no coinsurance, featuring copays ranging from no copay up to $350 for outpatient hospital services and up to $25 for substance abuse sessions. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, though prior authorization is required.
Partial Hospitalization See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP), featuring a $265 copay and no coinsurance for ground and air ambulance services. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $65 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) offers primary care, telehealth, podiatry, and opioid treatment with no copay and no coinsurance. Other covered services, including specialist visits, physical, occupational, speech, mental health, and psychiatric therapies, feature no coinsurance and copays ranging from $0 to $35. Chiropractic services are only partially covered, with routine and other chiropractic services not covered.
Preventive Services See details
Preventive Services under UHC Care Advantage WI-E001 (HMO-POS I-SNP) are covered with no copay and no coinsurance for annual physical exams, kidney disease education, and select screenings. Additional preventive services are partially covered, offering home and bathroom safety devices with no copay and no coinsurance, while sub-services like fitness benefits, health education, and personal emergency response systems are not covered.
Hearing Services See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) offers partially covered hearing services with no copay and no coinsurance for routine exams, prescription hearing aids up to $2,200 every two years, and OTC hearing aids. Fitting and evaluation exams are not covered, and inner ear, outer ear, and over the ear prescription hearing aids are also excluded.
Vision Services See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) provides partially covered vision services with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and a combined $300 annual allowance for contact lenses, eyeglass lenses, and eyeglass frames, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) because orthodontic services are not covered. Medicare-covered dental services have no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services feature no copay and no coinsurance up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) with no copay, though prior authorization and step therapy may apply. Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) with no copay and a 20% coinsurance for durable medical equipment and medical supplies, and 0% to 20% coinsurance for prosthetics. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay but subject to coinsurance. Diagnostic procedures and therapeutic radiological services require a 20% coinsurance, while diagnostic radiological services require a copay and no coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Care Advantage WI-E001 (HMO-POS I-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice by UHC Care Advantage WI-E001 (HMO-POS I-SNP). While the plan technically offers this benefit with no copay and no coinsurance, some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, though prior authorization is required. While a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Care Advantage WI-E001 (HMO-POS I-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services under this category are not covered.
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