A non-government entity
UHC Northern Light Health ME-0001 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Northern Light Health ME-0001 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Northern Light Health ME-0001 (HMO-POS) in 2026, please refer to our full plan details page.
UHC Northern Light Health ME-0001 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Maine. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Northern Light Health ME-0001 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Northern Light Health ME-0001 (HMO-POS).
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 Northern Light Health ME-0001 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $34.00. 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 $440.00 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 $5900.00 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 Northern Light Health ME-0001 (HMO-POS)
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 Northern Light Health ME-0001 (HMO-POS) prescription drug plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and mail-order services. Tier 2 generic drugs cost a $10 copay for a 1-month supply at standard pharmacies, but members can enjoy no copay for a 3-month supply through preferred mail order. For brand-name and specialty medications, the plan uses coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 19% coinsurance for both standard pharmacy and mail-order options. Tier 4 non-preferred drugs carry a 41% coinsurance for a 1-month supply, while Tier 5 specialty drugs require a 28% coinsurance.
Additional Benefits
The UHC Northern Light Health ME-0001 (HMO-POS) plan provides comprehensive medical coverage with favorable cost-sharing, highlighting no copay and no coinsurance for primary care, telehealth, home health, and preventive services. For inpatient hospital stays, members pay no coinsurance and a $395 daily copay for the first 5 to 7 days, with no copay required for subsequent days. Outpatient services and emergency care are also covered, though specialists require a copay up to $40, and ambulance services carry a $290 copay. This plan also includes essential supplemental benefits, featuring no copay for routine hearing exams, annual eye exams, and preventive dental care like cleanings and x-rays. While comprehensive dental is not covered, members can access diabetic supplies and home infusion services with no copay, whereas durable medical equipment and dialysis require a 20% coinsurance. Additionally, the plan offers benefits for over-the-counter items and chronic illness meals with no copay, helping to further reduce out-of-pocket costs.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Northern Light Health ME-0001 (HMO-POS) with no coinsurance, requiring a $395 daily copay for days 1 through 7 for acute stays and days 1 through 5 for psychiatric stays, with no copay for subsequent covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Northern Light Health ME-0001 (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay between $0 and $395 (with observation services costing a $395 copay per day), while outpatient substance abuse treatment has a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Northern Light Health ME-0001 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
UHC Northern Light Health ME-0001 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, with prior authorization required. Routine transportation services, including trips to plan-approved or any health-related locations, are not covered under this plan.
Emergency Services See details
Emergency services under UHC Northern Light Health ME-0001 (HMO-POS) are covered with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Northern Light Health ME-0001 (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies carry a $40 copay and no coinsurance, and mental health individual sessions range from a $0 to $25 copay with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered under the UHC Northern Light Health ME-0001 (HMO-POS) plan with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, kidney disease education, and glaucoma screenings. However, several supplemental options are not covered, including health education, in-home safety assessments, personal emergency response systems, weight management programs, and telemonitoring.
Hearing Services See details
UHC Northern Light Health ME-0001 (HMO-POS) partially covers hearing services with no deductibles, offering one routine hearing exam per year with no copay and no coinsurance, though hearing aid fittings and evaluations are not covered. Up to two prescription or OTC hearing aids are covered annually with no coinsurance and copays ranging from $199.00 to $1,249.00, but inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Northern Light Health ME-0001 (HMO-POS), offering one annual routine eye exam with no copay, deductible, or coinsurance, while other eye exam services are not covered. Eyewear is also partially covered with no coinsurance or deductible up to a $150 limit every two years, featuring contact lenses and frames with no copay and lenses with a $0 to $153 copay, though upgrades and complete eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Northern Light Health ME-0001 (HMO-POS), offering preventive care like oral exams, cleanings, fluoride, and x-rays with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance and no copay, but comprehensive services—including restorative, endodontics, periodontics, prosthodontics, implants, and oral surgery—are not covered.
Home Infusion bundled Services See details
UHC Northern Light Health ME-0001 (HMO-POS) covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, feature coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by UHC Northern Light Health ME-0001 (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Medical equipment is covered under UHC Northern Light Health ME-0001 (HMO-POS) with no copay and 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
UHC Northern Light Health ME-0001 (HMO-POS) covers diagnostic and radiological services with prior authorization required. Lab services and diagnostic radiological services are available with no copay and no coinsurance, while diagnostic tests require a $35 copay with no coinsurance, outpatient X-rays require a $30 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
UHC Northern Light Health ME-0001 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by UHC Northern Light Health ME-0001 (HMO-POS) with no copay and no coinsurance, though prior authorization is required. While some services are covered, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Northern Light Health ME-0001 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, but a prior three-day hospital stay is not, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Northern Light Health ME-0001 (HMO-POS) offers coverage for select other services, including over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture and other additional services are not covered under this plan.
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