UHC Nursing Home Plan EX-F004 (PPO I-SNP) (2027)

Institutional Special Needs Plan (Medicare Advantage) from UnitedHealthcare, plan ID H0710-032-000. Sold in 1 county in District Of Columbia, 15 counties in Maryland, 46 counties in Virginia.

★★★★★5.0

Who can join

Only for people who live in a nursing home or similar facility, or need that level of care at home.

2027 costs

Monthly premium$0
Drug deductible$700
Medical deductible$0
Out-of-pocket maximum (in network)$9,850
Plan typeInstitutional Special Needs Plan (Medicare Advantage), PPO
Referral needed to see a specialistNo
Plan IDH0710-032-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit0%–20%
Specialist visit0%–20%
Preventive care$0
Urgent care$0–$40
Emergency room$115
Hospital stay$0
Outpatient surgery0%–20%
Lab tests20%
X-rays and scans$0
Mental health visit0%–20%
Physical therapy$0
Medical equipment20%
TelehealthNot covered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $2000 allowance
VisionCovered — up to $300/yr allowance
HearingCovered — up to $2200 every 2 yrs allowance
Over-the-counter itemsCovered
FitnessNot covered
Rides to appointmentsCovered — 24 one-way trips/yr

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic$0$0$0
2 Generic$3$3$9
3 Preferred Brand25%25%25%
4 Non-Preferred Drug25%25%N/A
5 Specialty Tier25%25%N/A

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.