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UHC Medicare Advantage TX-0030 (Regional PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Medicare Advantage TX-0030 (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 TX-0030 (Regional PPO) in 2026, please refer to our full plan details page.
UHC Medicare Advantage TX-0030 (Regional PPO) is a Regional PPO plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Texas. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Medicare Advantage TX-0030 (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 TX-0030 (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 TX-0030 (Regional PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $102.00. 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 $8200.00 (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 $8200.00 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 TX-0030 (Regional PPO) plan has an annual drug deductible of $600. For Tier 1 preferred generic drugs, there is no copay for a 1-month or 3-month supply at standard pharmacies, or for a 3-month supply through preferred and standard mail order. Tier 2 generic drugs require a $14 copay for a 1-month supply at standard pharmacies, though you pay no copay for a 3-month supply filled via preferred mail order. For higher-tier medications, Tier 3 preferred brand drugs incur an 18% coinsurance for standard pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 27% and 26% coinsurance respectively for a 1-month supply across standard pharmacies and mail-order services.
Additional Benefits
The UHC Medicare Advantage TX-0030 (Regional PPO) offers comprehensive coverage for essential medical services with predictable costs and no coinsurance for many benefits. Primary care visits range from no copay up to $20, while specialist visits require a copay of up to $55. For hospital stays, you will pay a $485 copay for the first few days of inpatient care and no copay for subsequent days, while emergency room visits carry a $115 copay that is waived if you are admitted. Routine annual vision and hearing exams are available with no copay, though routine dental services and eyewear are not covered. Diagnostic lab services, home health visits, and telehealth are also fully covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Prescription hearing aids are covered with copays ranging from $199 to $1,249 per device with no coinsurance or deductible.
Inpatient Hospital See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers inpatient hospital services with no coinsurance, requiring a $485 copay for days 1 through 5 of acute stays and days 1 through 4 of psychiatric stays, followed by no copay for subsequent days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services under the UHC Medicare Advantage TX-0030 (Regional PPO) are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of $0 to $485, while outpatient substance abuse services have no coinsurance and copays ranging from $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered under UHC Medicare Advantage TX-0030 (Regional PPO) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers Medicare-approved ground and air ambulance services with a $290.00 copay and no coinsurance, requiring prior authorization. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of up to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and specialist services under the UHC Medicare Advantage TX-0030 (Regional PPO) feature no coinsurance, with copays ranging from no copay up to $20 for primary care and up to $55 for specialists. While chiropractic services are not covered, other benefits like occupational, physical, and speech therapies require copays of $35 to $55 with no coinsurance, and telehealth services are offered with no copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered by UHC Medicare Advantage TX-0030 (Regional PPO), providing annual physical exams, kidney disease education, and diabetes training with no copay and no coinsurance. However, several additional preventive benefits are not covered, including fitness benefits, health education, medical nutrition therapy, weight management programs, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by UHC Medicare Advantage TX-0030 (Regional PPO), providing one routine annual hearing exam with no copay or coinsurance, though fitting and evaluation exams and inner ear, outer ear, and over the ear prescription hearing aids are not covered. Covered prescription hearing aids have a copay of $199 to $1,249 and OTC hearing aids have a copay of $199 to $829, both with no coinsurance, no deductible, and a limit of two devices per year.
Vision Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers one routine eye exam per year with no deductible, no copay, and no coinsurance, subject to prior authorization. Other eye exams and all eyewear services, including eyeglasses and contact lenses, are not covered.
Dental Services See details
Dental Services under the UHC Medicare Advantage TX-0030 (Regional PPO) are partially covered, offering Medicare-covered dental services with no copay and a 20% coinsurance, subject to prior authorization. Other dental services, including routine cleanings, exams, x-rays, and orthodontic treatments, are not covered under this plan.
Home Infusion bundled Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance up to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Medicare Advantage TX-0030 (Regional PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Medicare Advantage TX-0030 (Regional PPO) with no coinsurance, though prior authorization is required. There is a $25 copay for diagnostic procedures and tests, a $30 copay for outpatient x-rays, and a $60 copay for therapeutic radiological services, while diagnostic radiological and lab services have no copay.
Home Health Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by the UHC Medicare Advantage TX-0030 (Regional PPO) with no copayment and no coinsurance, requiring prior authorization. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
UHC Medicare Advantage TX-0030 (Regional PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with additional days beyond the Medicare limit not covered.
Other Services See details
UHC Medicare Advantage TX-0030 (Regional PPO) indicates that some services are covered, but acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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