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) - Enhanced
2024 materials
Enhanced
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.
UnitedHealthcare® Group Medicare Advantage (PPO) - Base
2024 materials
Base
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.
Benefits and costs
Benefit | UnitedHealthcare® Group Medicare Advantage (PPO) – Base Plan | UnitedHealthcare® Group Medicare Advantage (PPO) – Enhanced Plan |
---|---|---|
Annual medical deductible | $300 | $0 |
Annual out-of-pocket maximum | $3,400 | $0 |
Office and clinic visits | $10 copay for primary care visit $20 copay for specialist visit |
$0 copay for primary care or specialist visit |
Hospital services (inpatient) | $200 copay per admission | $0 per admission |
Hospital services (outpatient) | $100 copay for surgery and observation | $0 copay |
Emergency care | $65 copay | $0 copay |
Urgent care | $35 copay | $0 copay |
Medically-necessary services outside the United States | $200,000 lifetime maximum | $200,000 lifetime maximum |
Prescription drug coverage | Retail: Tier 1 – Generic: 20% coinsurance $7 minimum Mail Order:(90-day supply) Tier 1 – Generic: 20% coinsurance $15 minimum After your total out-of -pocket costs reach $4130, you enter the Catastrophic Coverage stage. |
Retail: Tier 1 – Generic: 20% coinsurance $7 minimum Mail Order:(90-day supply) Tier 1 – Generic: 20% coinsurance $15 minimum After your total out-of-pocket costs reach $4130, you enter the Catastrophic Coverage stage. |
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.