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Coverage and benefits
Get a quick overview of your plan benefits and costs, and find more detailed information about additional coverage and benefit services. Note that you must be enrolled in Medicare Part A and Part B to be eligible for our retiree plans and you must continue to pay your Part B premium to the government as well as the employer-requested premium.
Important Information about your Part D Vaccine and Insulin Coverage
What You Pay for Vaccines – Our plan covers most adult Part D vaccines at no cost to you.
What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.
UnitedHealthcare® Group Medicare Advantage (PPO)
2025 materials
Core Plan
Plus Plan
Preventive services
The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:
- Annual Wellness Exam
- Annual Routine Physical
- Screenings for certain Cancers (Prostate, colorectal, breast cancer)
- Screening for diabetes
- Smoking and Tobacco Use Cessation
For more information about these preventive services, please call the Customer Service number on your member ID card.
Benefits and costs
| Benefit | UnitedHealthcare Group Medicare Advantage Core (PPO) | UnitedHealthcare Group Medicare Advantage Plus (PPO) |
|---|---|---|
| Annual medical deductible | $325 | $0 |
| Annual out-of-pocket maximum | $3,000 | $2,000 |
| Office and clinic visits | $30 copay for primary care $40 copay for specialist visit |
$25 copay for primary care $35 copay for specialist visit |
| Hospital services (inpatient) | $230 copay days 1-7 $0 copay days 8-999 |
$200 copay days 1 – 8 100% covered days 9+ |
| Hospital services (outpatient) | 20% coinsurance for observation, medical and surgical care | 20% coinsurance for observation, medical and surgical care |
| Prescription drug coverage | Retail Tier 1: $10 copay Mail Order (up to 90-day supply) Tier 1: $20 copay |
Retail Tier 1: $10 copay Mail Order (up to 90-day supply) Tier 1: $20 copay |
Disclaimer
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.