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UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) in 2025, please refer to our full plan details page.
UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) is a PFFS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in KS, MT, and WY. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS).
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 MedicareDirect Patriot No Rx PF-MA01 (PFFS), 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 $25.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
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
Prescription drugs are not covered by UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS).
Additional Benefits
The UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan offers comprehensive coverage, including inpatient hospital stays with a $420 copay for days 1-5, and no copay for days 6-90. Outpatient services have varying copays, while emergency services have a $125 copay, and primary care visits range from no copay to a $20 copay. Preventive services like annual physical exams and routine eye exams are covered with no copay, and there is coverage for hearing aids and eyewear. This plan also covers dental services with no copay for many procedures, and a 20% coinsurance for Medicare dental services. Home health services, skilled nursing facility stays, and dialysis services are covered, but cardiac rehabilitation and certain other services are not. Prescription hearing aids are covered with a maximum plan benefit coverage of $1500 every year.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. For inpatient hospital-acute and psychiatric care, you will pay a copay of $420 for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, with a copay ranging from $0 to $420, and observation services with a copay of $420 per day. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have copays ranging from $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. For this benefit, there is a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. Medicare-covered ground and air ambulance services have a $290 copay and no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgent Services, and Worldwide Emergency Services are covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. Emergency services have a $125 copay, while urgently needed services have a copay between $0 and $55; both have no coinsurance. Worldwide emergency coverage, urgent coverage, and emergency transportation have no copay and no coinsurance.
Primary Care See details
The UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan covers primary care physician services with a copay of $0-$20, chiropractic services with a $20 copay, occupational therapy services with a copay of $0-$45, physician specialist services with a copay of $0-$55, and mental health specialty services with a copay of $0-$25 for individual sessions and $15 for group sessions. This plan also covers podiatry services with a $45 copay, other health care professional services with a copay of $0-$55, psychiatric services with a copay of $0-$25 for individual sessions and $15 for group sessions, and physical therapy and speech-language pathology services with a copay of $0-$50. Additional telehealth benefits are covered with no copay, and opioid treatment program services are covered with no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, while other preventive services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. This plan does not cover Medicare-covered zero-dollar preventive services, and additional preventive services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing services include hearing exams with a $20 copay, and routine hearing exams with no copay for 1 visit every year. Prescription hearing aids are covered, with a maximum plan benefit coverage of $1500 every year, and OTC hearing aids are covered with no copay for 2 hearing aids every year. Fitting/evaluation for hearing aids, and Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
The UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan covers vision services, including routine eye exams with no copay. Eyewear is covered with no copay, and contact lenses and eyeglasses are covered, with a combined maximum of $100 per year. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics (removable and fixed) have a coinsurance between 0% and 50%. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay. Lab services have no copay, while diagnostic radiological services have a maximum copay of $250, and therapeutic radiological services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan with no copay and no coinsurance, but 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 MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) with no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered by the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan. Specifically, acupuncture, over-the-counter items, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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