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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 (PPO)
2024 materials
Standard plan
National PPO Plan Overview
- A national plan covering all eligible beneficiaries regardless of where they reside in the U.S., D.C. and 5 U.S. territories
- Visit doctors, specialists and hospitals in or out of our network for the same cost share as long as the provider participates in Medicare and accepts the plan and have not opted out of or been excluded from Medicare
- Coverage for visiting doctors, clinics and hospitals
- Routine podiatry, vision and hearing coverage
- Routine aid allowances
- No referral needed to see a specialist
Benefits and costs
| Benefit | UnitedHealthcare® Group Medicare Advantage (PPO) |
|---|---|
| Annual medical deductible | $0 |
| Annual out-of-pocket maximum | $2,400 |
| Office and clinic visits | $10 copay for primary care $20 copay for specialist visit |
| Hospital services (inpatient) | $500 copay per admission |
| Hospital services (outpatient) | $250 copay |
| Prescription drug coverage | Retail (30-day supply) Tier 1: $10 copay Mail order (90-day supply) Tier 1: Generic $25 copay |
| Maximum prescription drug annual out-of-pocket | $2,000 |
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.
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 costsharing that applies to out-of-network services.