Coverage and benefits

Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.

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- MAPD

2025 materials

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 information about these preventive services, please call the Customer Service number (1-844-675-1776) on your member ID card.

Benefits and costs

Plan options and costs
Benefits and costs

UnitedHealthcare Group Medicare Advantage - MAPD 

UnitedHealthcare Group Medicare Advantage - MAPD 
Annual medical deductible

None
Annual medical deductible

None
Annual out-of-pocket maxium

$1,000
Annual out-of-pocket maxium

$1,000
Office and clinic visits

$10 copay or

$10 for specialist visit
Office and clinic visits

$10 copay or

$10 for specialist visit
Emergency Room/Urgent Care

Emergency Room - $50

Urgent Care - $10
Emergency Room/Urgent Care

Emergency Room - $50

Urgent Care - $10
Hospital services (inpatient)

$0 Per Admit
Hospital services (inpatient)

$0 Per Admit
Hospital services (outpatient)

$0 copay
Hospital services (outpatient)

$0 copay
Hearing aids

Plan pays $2,000 allowance for hearing aids (combined for both ears) every 3 years. Hearing aids can be purchased with UnitedHealthcare Hearing’s nationwide network or out-of-network.
Hearing aids

Plan pays $2,000 allowance for hearing aids (combined for both ears) every 3 years. Hearing aids can be purchased with UnitedHealthcare Hearing’s nationwide network or out-of-network.
Prescription drug co-pays by tier – include Rx MOOP and Rx Deductible if applicable

Retail – 1 month supply

Tier 1 (Generic) – $10

Tier 2 (Preferred Brand) – $20

Tier 3 (Non-Preferred Brand) – $20

Tier 4 (Specialty) – $20 (limited to 30 day supply)

Mail Order– 1 month supply

Tier 1 (Generic) - $10

Tier 2 (Preferred Brand) - $20

Tier 3 (Non-Preferred Brand) - $20

Tier 4 (Specialty) - $20 (limited to 30 day supply)  

Mail Order– 3 month supply

Tier 1 (Generic) - $20

Tier 2 (Preferred Brand) - $40

Tier 3 (Non-Preferred Brand) - $40

Tier 4 –  N/A (limited to 30 day supply)   
Prescription drug co-pays by tier – include Rx MOOP and Rx Deductible if applicable

Retail – 1 month supply

Tier 1 (Generic) – $10

Tier 2 (Preferred Brand) – $20

Tier 3 (Non-Preferred Brand) – $20

Tier 4 (Specialty) – $20 (limited to 30 day supply)

Mail Order– 1 month supply

Tier 1 (Generic) - $10

Tier 2 (Preferred Brand) - $20

Tier 3 (Non-Preferred Brand) - $20

Tier 4 (Specialty) - $20 (limited to 30 day supply)  

Mail Order– 3 month supply

Tier 1 (Generic) - $20

Tier 2 (Preferred Brand) - $40

Tier 3 (Non-Preferred Brand) - $40

Tier 4 –  N/A (limited to 30 day supply)   

Important 2025 changes explained

For 2025, all stand-alone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage will be impacted by changes made by the federal government. This video provides an overview of those changes.

Learn more

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.