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)

2025 materials

MAPD plan

Coming soon

  • Plan guide (pdf)

  • Benefit Highlights (pdf)

  • Plan Resource Brochure (pdf)

  • Benefit Booklet (pdf)

MA plan

Coming soon

  • Plan guide (pdf)

  • Benefit Highlights (pdf)

  • Plan resources brochure (pdf)

  • Benefit Booklet (pdf)

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 1-877-298-2341, 8 a.m. – 8 p.m., CT, Monday - Friday. TTY users, call 711 on your member ID card.

Benefits and costs

Final 2025 Plan Changes are not yet available. Please check back for benefit updates.

Plan options and costs
Benefit and costs

UnitedHealthcare Group Medicare Advantage (PPO) - MAPD

UnitedHealthcare Group Medicare Advantage (PPO) - MAPD
Annual medical deductible

$226
Annual medical deductible

$226
Annual out-of-pocket mazimum

$8300
Annual out-of-pocket mazimum

$8300
Office visits

$13 Office

$18 Specialist
Office visits

$13 Office

$18 Specialist
Hospital services (inpatient)

$200 per day: Day 1 copay

$25 per day: Days 2 - 5 copay

$0 per day: Days 6 copay
Hospital services (inpatient)

$200 per day: Day 1 copay

$25 per day: Days 2 - 5 copay

$0 per day: Days 6 copay
Hospital services (outpatient)

$0 copay
Hospital services (outpatient)

$0 copay
Prescription drug coverage

Retail

Tier 1: $6   copay
Tier 2: $40 copay
Tier 3: $60 copay
Tier 4: $60 (limited to 30 day supply)

Rx Out of pocket: $8000
Rx Deductible: $0
Prescription drug coverage

Retail

Tier 1: $6   copay
Tier 2: $40 copay
Tier 3: $60 copay
Tier 4: $60 (limited to 30 day supply)

Rx Out of pocket: $8000
Rx Deductible: $0

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.