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UHC Nursing Home Plan EX-F006 (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 EX-F006 (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 EX-F006 (HMO-POS I-SNP) in 2025, please refer to our full plan details page.
UHC Nursing Home Plan EX-F006 (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 Miami-Dade and Ocean 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 EX-F006 (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 EX-F006 (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 EX-F006 (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 EX-F006 (HMO-POS I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $23.00. 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 $1500.00 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 EX-F006 (HMO-POS I-SNP) has a $590 deductible for prescription drugs. Once the deductible is met, you will pay the costs for your drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, your monthly premium for Part D will be $31.40. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) offers comprehensive coverage, including inpatient hospital stays with a $1500 copay, and outpatient services with varying coinsurance. This plan provides a range of services with no copay, such as primary care, preventive services, hearing exams, vision exams, dental services, home health, and skilled nursing facility stays for the first 100 days. Additional benefits include coverage for ambulance and transportation, with a 20% coinsurance for ambulance services and no copay for limited transportation to health-related locations. The plan also covers medical equipment, diagnostic services, and home infusion bundled services with specific copays and coinsurance. However, note that certain services like Cardiac Rehabilitation, and some other services are not covered.
Inpatient Hospital See details
Inpatient hospital services are covered, including acute and psychiatric care, each with a $1500 copay for a Medicare-covered stay. Additional days and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a 0% - 20% coinsurance, observation services with a 20% coinsurance, ambulatory surgical center services with a 0% - 20% coinsurance, outpatient substance abuse services with a 0% - 20% coinsurance, and outpatient blood services with a 0% - 20% coinsurance. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP). Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to a plan-approved health-related location have no copay and are limited to 18 one-way trips per year. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered, with a $110 copay for emergency services. Urgently Needed Services are covered with a copay between $0 and $40, and Worldwide Emergency Services are not covered.
Primary Care See details
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) plan covers primary care physician services with no copay, and covers chiropractic services with a 0% to 20% coinsurance. Occupational therapy services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services are covered with no copay, and mental health specialty services, physician specialist services, podiatry services, psychiatric services, and other health care professional services are also covered with varying coinsurance and copay costs.
Preventive Services See details
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) plan covers preventive services including an annual physical exam with no copay, as well as additional preventive services, kidney disease education services, and other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Glaucoma screenings, digital rectal exams, and EKGs have a 20% maximum coinsurance.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams are covered with no copay and no coinsurance, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a maximum benefit of $2200 per year, with no copay for prescription hearing aids (all types). OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Routine eye exams have no copay and a coinsurance of 0%, and are limited to one exam per year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay. Eyeglass frames and lenses are limited to one pair per year, and there is a combined maximum of $150 per year for all eyewear.
Dental Services See details
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) plan covers dental services including exams, x-rays, and cleanings with no copay, as well as other diagnostic and preventive services with no copay. This plan also covers restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, and oral and maxillofacial surgery with no copay. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. 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 by the UHC Nursing Home Plan EX-F006 (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 (DME) with 20% coinsurance and no copay, and Prosthetics/Medical Supplies with 20% coinsurance and no copay. Diabetic Equipment is covered, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) covers diagnostic and radiological services. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 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 EX-F006 (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 EX-F006 (HMO-POS I-SNP). Prior authorization is required for these services, but all Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP). There is no copay for days 1-100.
Other Services See details
The UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP) plan covers 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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