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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 2025, 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 2025.
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 $89.00. 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 $495.00 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 $14000.00 (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 $14000.00 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 has an enhanced alternative drug benefit. The plan has a $495 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, you may pay a $20 copay for a preferred generic drug at a standard pharmacy. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The UHC Medicare Advantage AM-0002 (Regional PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have varying copays depending on the service. Emergency services have a copay, while primary care visits and preventive services have no copay. The plan covers hearing exams, vision exams, and dental services with no copay. It also covers home health services with no copay. Other services such as ambulance, partial hospitalization, and medical equipment have copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the UHC Medicare Advantage AM-0002 (Regional PPO) plan. For inpatient hospital-acute services, you'll pay a $475 copay for days 1-5, and no copay for days 6-90, and for inpatient hospital psychiatric services, you'll pay a $475 copay for days 1-4, and no copay for days 5-90. Additional days for inpatient hospital-acute are covered with no copay for days 91-999, while additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered under the UHC Medicare Advantage AM-0002 (Regional PPO) plan. Outpatient Hospital Services have a copay between $0 and $475, Observation Services have a copay of $475, ASC Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse have a copay of $15, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Medicare Advantage AM-0002 (Regional PPO) plan. Ground and air ambulance services have a $290 copay, and there is no coinsurance. 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 AM-0002 (Regional PPO) plan. Emergency Services have a $110 copay, and no coinsurance. Urgently Needed Services have a copay between $0-$45, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Medicare Advantage AM-0002 (Regional PPO) plan covers primary care physician services with no copay. Chiropractic services have a $15 copay, but routine care is not covered, and also requires prior authorization. Occupational therapy services have a copay ranging from $0 to $35. Physician specialist services have a copay between $0 and $55, while mental health individual sessions have a copay between $0 and $25 and group sessions have a $15 copay. Podiatry services, including routine foot care, have a $45 copay, with a limit of 6 visits per year. Other health care professional services have a copay between $0 and $55. Psychiatric services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $50. Additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services including Remote Access Technologies with no copay. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, or Counseling Services. Other services, such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing Services includes hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249, while OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision Services include coverage for eye exams with no copay, but routine eye exams are limited to one per year. Eyewear benefits are covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with a 20% coinsurance, oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services, all with no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are 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. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while the other drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Medicare Advantage AM-0002 (Regional PPO) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered under this plan. Durable Medical Equipment has a 20% coinsurance, while Prosthetic Devices and Medical Supplies also have a 20% coinsurance and no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay of $80, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have a copay of $35.
Home Health Services See details
Home Health Services are covered by the UHC Medicare Advantage AM-0002 (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 covered, but the plan does not specify the copay or coinsurance. However, the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Medicare Advantage AM-0002 (Regional PPO) plan, with a $0 copay for days 1-20 and a $203 copay per day for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services for UHC Medicare Advantage AM-0002 (Regional PPO) includes a Meal Benefit with no copay; however, acupuncture, over-the-counter items, 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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