UnitedHealthcare MedicareDirect Patriot (PFFS)
H5435 - 001 - 0
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UnitedHealthcare MedicareDirect Patriot (PFFS) is a Medicare Advantage (Part C) Plan by UnitedHealthcare.
This page features plan details for 2023 UnitedHealthcare MedicareDirect Patriot (PFFS) H5435 – 001 – 0 available in Select counties nationwide.
IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link below:
Locations
UnitedHealthcare MedicareDirect Patriot (PFFS) is offered in the following locations.
Plan Overview
UnitedHealthcare MedicareDirect Patriot (PFFS) offers the following coverage and cost-sharing.
| Insurer: | UnitedHealthcare |
| Health Plan Deductible: | $0.00 |
| MOOP: | $6,700.00 |
| Drugs Covered: | No |
Ready to sign up for UnitedHealthcare MedicareDirect Patriot (PFFS) ?
Premium Breakdown
UnitedHealthcare MedicareDirect Patriot (PFFS) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $164.90 | $0.00 | $0.00 | $164.90 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
Additional Benefits
UnitedHealthcare MedicareDirect Patriot (PFFS) also provides the following benefits.
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
| In-Network: No |
Dental (comprehensive)
| Diagnostic services: | Not covered (no limits) |
| Endodontics: | Not covered (no limits) |
| Extractions: | Not covered (no limits) |
| Non-routine services: | Not covered (no limits) |
| Periodontics: | Not covered (no limits) |
| Prosthodontics, other oral/maxillofacial surgery, other services: | Not covered (no limits) |
| Restorative services: | Not covered (no limits) |
Dental (preventive)
| Cleaning: | Not covered (no limits) |
| Dental x-ray(s): | Not covered (no limits) |
| Fluoride treatment: | Not covered (no limits) |
| Oral exam: | Not covered (no limits) |
Diagnostic procedures/lab services/imaging
| Diagnostic radiology services (e.g., MRI): | $0-150 copay |
| Diagnostic tests and procedures: | $25 copay |
| Lab services: | $0 copay |
| Outpatient x-rays: | $15 copay |
Doctor visits
| Primary: | $20 copay per visit |
| Specialist: | $50 copay per visit |
Emergency care/Urgent care
| Emergency: | $90 copay per visit (always covered) |
| Urgent care: | $40 copay per visit (always covered) |
Foot care (podiatry services)
| Foot exams and treatment: | $50 copay |
| Routine foot care: | $50 copay (limits may apply) |
Ground ambulance
| $250 copay |
Health plan deductible
| $0.00 |
Health plan deductibles (other)
| In-Network: No |
Hearing
| Fitting/evaluation: | Not covered (no limits) |
| Hearing aids – inner ear: | Not covered (no limits) |
| Hearing aids – outer ear: | Not covered (no limits) |
| Hearing aids – over the ear: | Not covered (no limits) |
| Hearing exam: | $20 copay |
Hospital coverage (inpatient)
| $395 per day for days 1 through 4 $0 per day for days 5 through 90 $0 per day for days 91 and beyond |
Hospital coverage (outpatient)
| $0-395 copay per visit |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
| $6,700.00 |
Medical equipment/supplies
| Diabetes supplies: | $0 copay per item |
| Durable medical equipment (e.g., wheelchairs, oxygen): | 20% coinsurance per item |
| Prosthetics (e.g., braces, artificial limbs): | 20% coinsurance per item |
Medicare Part B drugs
| Chemotherapy: | 20% coinsurance |
| Other Part B drugs: | 0-20% coinsurance |
Mental health services
| Inpatient hospital – psychiatric: | $395 per day for days 1 through 4 $0 per day for days 5 through 90 |
| Outpatient group therapy visit: | $15 copay |
| Outpatient group therapy visit with a psychiatrist: | $15 copay |
| Outpatient individual therapy visit: | $25 copay |
| Outpatient individual therapy visit with a psychiatrist: | $25 copay |
Optional supplemental benefits
| No |
Preventive care
| $0 copay |
Rehabilitation services
| Occupational therapy visit: | $40 copay |
| Physical therapy and speech and language therapy visit: | $40 copay |
Skilled Nursing Facility
| $0 per day for days 1 through 20 $196 per day for days 21 through 55 $0 per day for days 56 through 100 |
Transportation
| Not covered |
Vision
| Contact lenses: | Not covered (no limits) |
| Eyeglass frames: | Not covered (no limits) |
| Eyeglass lenses: | Not covered (no limits) |
| Eyeglasses (frames and lenses): | Not covered (no limits) |
| Other: | Not covered (no limits) |
| Routine eye exam: | $0 copay (limits may apply) |
| Upgrades: | Not covered |
Wellness programs (e.g., fitness, nursing hotline)
| Covered |
Ready to sign up for UnitedHealthcare MedicareDirect Patriot (PFFS) ?