Coverage and benefits
Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.
UnitedHealthcare® Group Medicare Advantage (PPO)
2022 materials
Standard plan
Standard plan
Standard plan
Preventive services
The following preventive services are covered under your plan for a $0 copay when you visit your primary care physician:
- Screening and counseling to reduce alcohol misuse
- Screening for depression in adults
- Screening for Sexually Transmitted Infections (STIs) and high intensity behavioral counseling to prevent STIs
- Intensive behavioral therapy to reduce cardiovascular disease risk
- Screening and counseling for obesity
For more information about these preventive services, please call the Customer Service number on your plan ID card.
Benefits and costs
Benefit | UnitedHealthcare® Group Medicare Advantage (HMO) | UnitedHealthcare® Group Medicare Advantage (PPO) |
---|---|---|
Annual medical deductible | None | $150 deductible on first inpatient hospitalization annually |
Annual out-of-pocket maximum | $4,000 | $5,000 |
Office and clinic visits | $15 copay for primary care $30 copay for specialist visit |
$15 copay for primary care $25 copay for specialist visit |
Hospital services (inpatient) | $100 copay per admission | $0 after $150 annual inpatient deductible has been met |
Hospital services (outpatient) | $50 copay for each Medicare-covered emergency room visit (waived if admitted) | $50 copay for each Medicare-covered emergency room visit (waived if admitted) |
Prescription drug coverage | $15 copay for each Medicare-covered urgently needed care visit $10 copay generic Tier 1 $20 coapy generic Tier 1 mail-order |
$15 copay for each Medicare-covered urgently needed care visit $10 copay generic Tier 1 $20 coapy generic Tier 1 mail-order |
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.