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UHC MedicareMax Medicare Advantage FL-0029 (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC MedicareMax Medicare Advantage FL-0029 (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC MedicareMax Medicare Advantage FL-0029 (HMO) in 2026, please refer to our full plan details page.
UHC MedicareMax Medicare Advantage FL-0029 (HMO) is a HMO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Broward County. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC MedicareMax Medicare Advantage FL-0029 (HMO) 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 MedicareMax Medicare Advantage FL-0029 (HMO).
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 MedicareMax Medicare Advantage FL-0029 (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $12.00. 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 $340.00 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 $2900.00 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 MedicareMax Medicare Advantage FL-0029 (HMO) plan features an annual prescription drug deductible of $340. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay for one-month or three-month supplies filled at standard pharmacies, and no copay for three-month supplies through standard mail order. This makes managing everyday health needs highly affordable during the initial coverage phase. For higher-tier medications, the plan transitions to coinsurance costs rather than flat copays. Tier 3 preferred brand drugs require a 19% coinsurance for both standard pharmacy and standard mail order options. Tier 4 non-preferred drugs carry a 41% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for one-month supplies at standard pharmacies and standard mail order.
Additional Benefits
The UHC MedicareMax Medicare Advantage FL-0029 (HMO) offers comprehensive healthcare coverage with no copays for primary care visits, telehealth, and preventive services. For specialized care, members can expect low copays ranging from $0 to $25 for specialist visits and no coinsurance for most diagnostic services. Emergency room visits carry a $150 copay, which is waived if admitted, while inpatient hospital stays require a $195 daily copay for the first five days and no copay thereafter. This plan also features excellent supplemental benefits, including dental cleanings, annual eye exams, and up to $300 yearly for eyewear with no copays or coinsurance. Additionally, members benefit from no copays on durable medical equipment, home health services, and over-the-counter items. Routine hearing exams are also covered with no copay, though hearing aids require a copayment depending on the model.
Inpatient Hospital See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $195 daily copay for days 1 to 5 and no copay for days 6 to 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers outpatient services with no coinsurance, although prior authorization is required for most services. There is no copay for ambulatory surgical center and blood services, while outpatient hospital visits range from no copay to $195, observation services cost a $195 daily copay, and outpatient substance abuse sessions carry a $0 to $25 copay.
Partial Hospitalization See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers ground and air ambulance services with a $150 copay and no coinsurance, though prior authorization is required. Routine transportation services are not covered, including transportation to plan-approved or any other health-related locations.
Emergency Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers emergency services with a $150 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services range from no copay to a $65 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copays and no coinsurance.
Primary Care See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers primary care and telehealth visits with no copay and no coinsurance, while specialist visits require a $0 to $25 copay and no coinsurance. Physical, occupational, and speech therapy require a $20 copay and no coinsurance, but chiropractic services are not covered. Mental health, psychiatric, and podiatry services are covered with no coinsurance and copays ranging up to $25.
Preventive Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) provides partially covered preventive services with no copays and no coinsurance, which includes annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training. While fitness benefits and home safety modifications are covered with no copay, other supplemental services like health education, nutritional therapy, and personal emergency response systems are not covered.
Hearing Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers hearing services with no coinsurance, offering one routine hearing exam per year with no copay, though fitting and evaluation exams are not covered. Prescription hearing aids (up to two per year) require a copay of $199 to $1,249, and OTC hearing aids (up to two per year) require a copay of $199 to $829, both with no coinsurance, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC MedicareMax Medicare Advantage FL-0029 (HMO) with no deductible, no copay, and no coinsurance, offering one annual routine eye exam and up to $300 yearly for contact lenses, upgrades, and combined eyeglasses (lenses and frames). Prior authorization is required for exams, and other eye exam services, standalone eyeglass lenses, and standalone eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC MedicareMax Medicare Advantage FL-0029 (HMO) with no copay and no coinsurance for covered care, including exams, cleanings, x-rays, fluoride, restorative services, oral surgery, and removable prosthodontics. However, sub-services such as endodontics, periodontics, implants, fixed prosthodontics, orthodontics, adjunctive general services, and maxillofacial prosthetics are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC MedicareMax Medicare Advantage FL-0029 (HMO) with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and require no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the UHC MedicareMax Medicare Advantage FL-0029 (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers medical equipment with no copay and no coinsurance for durable medical equipment (DME), and no copay for diabetic supplies. A 20% coinsurance applies to Medicare-covered prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts, with prior authorization required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC MedicareMax Medicare Advantage FL-0029 (HMO) with no coinsurance, though prior authorization is required. Members pay no copay for lab services, outpatient X-rays, and diagnostic radiology, while diagnostic tests require a $5 copay and therapeutic radiology requires a $30 copay.
Home Health Services See details
Home health services are covered by UHC MedicareMax Medicare Advantage FL-0029 (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC MedicareMax Medicare Advantage FL-0029 (HMO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are all listed as not covered. Although the overall benefit technically lists no coinsurance, there is no coverage in practice for any of these rehabilitation sub-services.
Skilled Nursing Facility (SNF) See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not needed for admission, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
UHC MedicareMax Medicare Advantage FL-0029 (HMO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. Prior authorization is required for the meal benefit.
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