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Coverage and benefits
Once you are a member of the UnitedHealthcare® Group Medicare Advantage (PPO) plan with prescription drugs, you can see any provider (in-network or out-of-network) at the same cost share, as long as they accept the plan and have not opted out of or been excluded or precluded from the Medicare Program.
Find out more by reviewing your plan benefits and costs, additional benefits and programs. If you need a printed copy of plan materials, please call UnitedHealthcare at 844-320-5021, 8 a.m. – 8 p.m. local time, Monday through Friday. TTY users, call 711.
Important Information about your Part D Vaccine and Insulin Coverage
What You Pay for Vaccines – Our plan covers most 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, no matter what cost-sharing tier it’s on. You may pay less depending on your plan coverage. Refer to your plan materials.
UnitedHealthcare® Group Medicare Advantage (PPO) plan with prescription drugs (MAPD)
General Status Members
2023 materials
General Status Members
Protected Status Members
2023 materials
Protected Status
General Status Members Benefits and costs
| Annual medical deductible | $150 |
|---|---|
| Primary out-of-pocket maximum | $500 |
| Total out-of-pocket maximum | $1,500 |
| Telephonic Nurse Support |
$0 |
| Virtual Doctor Visit with AmWell, Doctors on Demand & Teladoc | $0 |
| Primary Care Physician office visit | $10 |
| Specialist office visit | $20 |
| Urgent Care | $25 |
| Emergency Room | $50 |
| Hospital services (inpatient) | 10% |
| Hospital services (outpatient) | 10% |
Prescription drug coverage
|
Deductible: None Annual out-of-pocket maximum: $1,500 for Tiers 1 and 2 only Retail 31-day supply; same as 90-day mail order Tier 1 - Preferred Generic: $5 |
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.