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UHC Medicare Advantage Patriot No Rx NY-MA02 (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 NY-MA02 (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 NY-MA02 (Regional PPO) in 2025, please refer to our full plan details page.
UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) is a Regional PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of New York. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Medicare Advantage Patriot No Rx NY-MA02 (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 NY-MA02 (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 NY-MA02 (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 $100.00. 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 $10100.00 (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 $10100.00 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 NY-MA02 (Regional PPO).
Additional Benefits
The UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, and outpatient services like hospital visits and substance abuse treatment have copays. Emergency and urgent care services have copays, and ambulance services have a $290 copay. This plan includes coverage for primary care, preventive, hearing, vision, and dental services. Many services, such as primary care visits, preventive care, and some hearing and vision services, have no copay. There are also additional benefits like home health services with no copay, and coverage for medical equipment, with some services requiring coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, there is a $495 copay for days 1-5, and no copay for days 6-90; additional days have no copay. For Inpatient Hospital Psychiatric, there is a $495 copay for days 1-4, and no copay for days 5-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and 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 by the UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan. Outpatient Hospital Services have a copay between $0 and $495, Observation Services have a $495 copay, Ambulatory Surgical Center (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 $15 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan. Ground and air ambulance services have a copay of $290, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered with a $125 copay and no coinsurance, and urgently needed services have a copay of $0-$55 with no coinsurance. Worldwide emergency services are also covered, with no copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay from $0 to $40, Physician Specialist Services with a copay from $0 to $50, and Mental Health Specialty Services with a copay from $0 to $25 for individual sessions and a $15 copay for group sessions. The plan also covers Podiatry Services with a $45 copay, Other Health Care Professional services with a copay from $0 to $50, Psychiatric Services with a copay from $0 to $25 for individual sessions and a $15 copay for group sessions, Physical Therapy and Speech-Language Pathology Services with a copay from $0 to $40, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include no copay for an annual physical exam. Additional preventive services, including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, and Other Preventive Services (including 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 exams are covered with no copay, and routine hearing exams are covered with no copay for 1 visit every year. Prescription hearing aids are partially covered, with a copay ranging from $199 to $1249 for all types of prescription hearing aids, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay ranging from $99 to $829.
Vision Services See details
The UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan covers vision services including eye exams and eyewear. Eye exams and eyewear have no copay. Eyeglass lenses have a copay between $0.00 and $153.00. Eyeglass frames and contact lenses are covered. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Insulin has a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but prior authorization is required. 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 20% coinsurance with no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have 20% coinsurance with no copay. Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a $45 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) 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 by the UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) plan, but the plan does not cover any of the specific services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with no 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.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) items and Meal Benefit, both with no copay, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and other services are not covered. The Meal Benefit requires prior authorization.
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