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

Please call Customer Service toll-free at 1 -800-430-5471, TTY 711, 8 a.m. – 8 p.m. local time, Monday through Friday to request plan materials.

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

Benefits and costs
Benefits and costs UnitedHealthcare® Group Medicare Advantage (PPO)
Annual medical deductible $0
Annual out-of-pocket maximum $1,500
Office and clinic visits $25 copay primary care
$35 copay specialist visit
Hospital services (inpatient) Days 1-8: $200 copay per day
Hospital services (outpatient) 20% coinsurance
Annual Rx deductible $590
Part D Prescription Drug Coverage*

Retail

$10 copay generic
$47 copay brand
$75 copay non-preferred brand
$100 copay specialty

Mail Order

$20 copay generic
$94 copay preferred brand
$150 copay non-preferred brand
$200 copay specialty

Specialty / Catastrophic

$0 copay generic
$0 copay all others

*Although most drugs are covered under your Part D benefit, some drugs may be covered under Medicare Part B and subject to different cost sharing. To learn more, refer to your Summary of Benefits or call UnitedHealthcare Customer Service.

Important 2025 changes explained

For 2025, all stand-alone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage will be impacted by changes made by the federal government. This video provides an overview of those changes.

Learn more

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.