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

Protected Status Members

2023 materials

General Status Members Benefits and costs

Benefits and costs
Annual medical deductible $150
Primary out-of-pocket maximum $500
Total out-of-pocket maximum $1,500
Telephonic Nurse Support
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
Tier 2 - Preferred Brand: $40
Tier 3 - Non-Preferred Drug: $115


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.