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UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) in 2025, please refer to our full plan details page.
UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) is a Regional PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in States of Georgia and South Carolina. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) 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 Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO).
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 Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO), 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 $18.00. 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
This plan has a combined Maximum Out-Of-Pocket cost of $9350.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9350.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page 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 Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO).
Additional Benefits
The UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan offers coverage for a wide range of services, including inpatient and outpatient care, with varying copays. Emergency, primary care, preventive, hearing, vision, and dental services are also covered, some with no copay. Additionally, the plan provides coverage for home health, home infusion, and skilled nursing facility services, with some services requiring prior authorization and some with coinsurance. Other benefits include coverage for ambulance, diagnostic, and medical equipment services. However, certain services like cardiac rehabilitation, and many other services such as acupuncture and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $475 for days 1-5 (Acute) and days 1-4 (Psychiatric), and no copay for days 6-90 (Acute and Psychiatric). Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered under the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan. Outpatient Hospital Services have a copay between $0 and $475, while Observation Services have a $475 copay. Ambulatory Surgical Center Services and Outpatient Blood Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, and Group Sessions for Outpatient Substance Abuse have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan. Both 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, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan. Emergency Services has a $110 copay, while Urgently Needed Services has a copay between $0 and $45, and Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation. There is no coinsurance for any of these services.
Primary Care See details
The UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan covers primary care physician services with no copay. Chiropractic services have a $15 copay, while routine chiropractic care is not covered. Occupational Therapy services have a copay between $0 and $35, and physician specialist services have a copay between $0 and $55. Mental health specialty services and psychiatric services have copays that vary between $0 and $25 for individual sessions and $15 for group sessions. Podiatry services, other health care professional services, physical therapy, and speech-language pathology services have copays that vary from $0 to $55, and additional telehealth benefits have no copay. Opioid Treatment Program Services also have no copay.
Preventive Services See details
The UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan covers preventive services, including an annual physical exam with no copay, and additional preventive services with a copay listed in the plan details. The plan also covers fitness benefits and remote access technologies with no copay. Some services, such as Health Education, In-Home Safety Assessment, and others, are not covered.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, while routine hearing exams are limited to 1 per year. Prescription hearing aids have a copay between $199 and $1249 for all types, but inner, outer, and over-the-ear hearing aids are not covered. OTC hearing aids have a copay between $99 and $829 for up to 2 per year.
Vision Services See details
Vision Services include eye exams with no copay, and eyewear with no copay for contact lenses, and eyeglass frames, and a copay between $0 and $153 for eyeglass lenses. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include Medicare dental services with 20% coinsurance, oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery 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. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan, but require prior authorization. You will pay 20% coinsurance for these 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; Prosthetics/Medical Supplies have a 20% coinsurance; and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $225, and Outpatient X-Ray Services have a $40 copay. Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan 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 Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan, but require prior authorization. For days 1-20, there is no copay, while days 21-100 have a $203 copay; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) plan does not cover acupuncture, over-the-counter items, meal benefits, 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, or self-directed personal assistance services. No authorization or referral is required for any of these services.
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