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UHC Medicare Advantage AM-0002 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage AM-0002 (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 AM-0002 (Regional PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage AM-0002 (Regional PPO) is a Regional PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in States of Arkansas and Missouri. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage AM-0002 (Regional PPO) 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 Medicare Advantage AM-0002 (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 AM-0002 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $106.00. 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 $600.00 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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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
The UHC Medicare Advantage AM-0002 (Regional PPO) plan offers an Enhanced Alternative drug benefit with a prescription drug deductible of $600.00. Under the initial coverage phase, you will have no copay for Tier 1 preferred generic drugs at standard pharmacies, while Tier 2 standard generics require a 20% coinsurance. This phase lasts until your total combined drug costs reach $2,100.00. For higher tier medications, you will pay a 35% coinsurance for Tier 3 preferred brand drugs and a 26% coinsurance for Tier 4 non-preferred drugs at standard pharmacies and standard mail. Once your yearly out-of-pocket costs hit $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, the plan's Part D premium is $73.20, which can be reduced to $44.10 for those qualifying for Full Extra Help.
Additional Benefits
The UHC Medicare Advantage AM-0002 (Regional PPO) plan offers robust coverage for essential medical services with predictable out-of-pocket costs. Members enjoy no copay and no coinsurance for primary care visits, preventive care, and home health services. Specialist visits require copays up to $55, while inpatient hospital stays incur a daily copay of $485 for the first few days before transitioning to no copay. Emergency care is available for a $115 copay, and routine hearing and vision exams are provided with no copay. For medical equipment, dialysis, and Medicare-covered dental services, members typically pay a 20% coinsurance with no copay. While preventive dental cleanings are covered with no copay, it is important to note that comprehensive dental work and eyewear are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by UHC Medicare Advantage AM-0002 (Regional PPO) with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Acute admissions require a $485 daily copay for days 1-5 and no copay for days 6-999, while psychiatric stays require a $485 daily copay for days 1-4 and no copay for days 5-90.
Outpatient Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Copayments range from $0 to $485 for outpatient hospital services, $485 per day for observation services, and $0 to $25 for outpatient substance abuse sessions.
Partial Hospitalization See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by UHC Medicare Advantage AM-0002 (Regional PPO), offering ground and air ambulance services for a $290 copay and no coinsurance. Transportation services to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by UHC Medicare Advantage AM-0002 (Regional PPO) with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers primary care visits, telehealth, and opioid treatment with no copay and no coinsurance, while other specialist and therapy services require copays up to $55 and no coinsurance. Chiropractic services are only partially covered because routine chiropractic care is not covered.
Preventive Services See details
Preventive services are partially covered by UHC Medicare Advantage AM-0002 (Regional PPO) with no copay and no coinsurance for covered care, such as annual physical exams, kidney disease education, and glaucoma screenings. However, additional benefits like health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, extra smoking cessation sessions, fitness benefits, disease management, telemonitoring, remote access, bathroom safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Medicare Advantage AM-0002 (Regional PPO), offering one routine hearing exam per year with no copay and no coinsurance. Covered prescription and OTC hearing aids have copays ranging from $199 to $1,249 with no coinsurance, but hearing aid fittings and inner, outer, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers one routine eye exam every year with no copay and no coinsurance, though prior authorization is required. While some eyewear services are covered, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) partially covers dental services, providing Medicare-covered dental care for a 20% coinsurance and no copay, and preventive services like cleanings, exams, and X-rays with no copay and no coinsurance. However, several sub-services are not covered, including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, orthodontics, adjunctive general, and maxillofacial prosthetic services.
Home Infusion bundled Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers home infusion bundled services with prior authorization, requiring a $35 copay and no coinsurance to 20% coinsurance for Medicare Part B insulin drugs. Other covered Part B chemotherapy, radiation, and miscellaneous drugs have no copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC Medicare Advantage AM-0002 (Regional PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment benefits are covered by UHC Medicare Advantage AM-0002 (Regional PPO) and require prior authorization for most services. Durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts require a 20% coinsurance and no copay, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) covers diagnostic and radiological services, which require prior authorization. Members pay no copay and no coinsurance for lab services, an $80 copay and no coinsurance for diagnostic tests, a $30 copay and no coinsurance for outpatient X-rays, a $0 to $260 copay and no coinsurance for diagnostic radiology, and a 20% coinsurance with no copay for therapeutic radiology.
Home Health Services See details
Home health services are covered by UHC Medicare Advantage AM-0002 (Regional PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Medicare Advantage AM-0002 (Regional PPO), where some services are covered but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage AM-0002 (Regional PPO) partially covers Skilled Nursing Facility (SNF) services with prior authorization required, though additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance.
Other Services See details
UHC Medicare Advantage AM-0002 (Regional PPO) partially covers other services, providing a meal benefit with no copay and no coinsurance, though prior authorization is required. Acupuncture, over-the-counter (OTC) items, and dual-eligible SNPs are not covered under this plan.
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