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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)
2024 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 |
UnitedHealthcare® Group Medicare Advantage (PPO) |
|---|---|
|
UnitedHealthcare® Group Medicare Advantage (PPO) |
|
| Annual medical deductible |
$300 (only applies to services with coinsurance) |
| Annual medical deductible | |
|
$300 (only applies to services with coinsurance) |
|
| Annual out-of-pocket maximum |
$1,500 |
| Annual out-of-pocket maximum | |
|
$1,500 |
|
| Office and clinic visits |
$15 copay for primary care $30 copay for specialist visit $0 virtual visit |
| Office and clinic visits | |
|
$15 copay for primary care $30 copay for specialist visit $0 virtual visit |
|
| Part B drugs |
20% coinsurance $0 for Diabetic Monitoring Supplies |
| Part B drugs | |
|
20% coinsurance $0 for Diabetic Monitoring Supplies |
|
| Hospital services ( inpatient ) |
$150 copay per admit |
| Hospital services ( inpatient ) | |
|
$150 copay per admit |
|
| Hospital services ( outpatient ) |
$100 copay |
| Hospital services ( outpatient ) | |
|
$100 copay |
|
| Urgent Care |
$50 copay ( waived if admitted ) |
| Urgent Care | |
|
$50 copay ( waived if admitted ) |
|
| Emergency room |
$100 copay ( waived if admitted) |
| Emergency room | |
|
$100 copay ( waived if admitted) |
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.