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Medicare Advantage with drug coverage · PPO · Plan ID H2001-028

UHC Medicare Advantage NH-001A (PPO)

Offered by UnitedHealthcare (UnitedHealth Group, Inc.) · available in 4 counties in NH

Monthly premium$7.50health + drug coverage
Yearly out-of-pocket max$9,850in network
Drug deductible$700Defined Standard
Star Rating★★★★½ 4.5 out of 52027 CMS rating

Extra benefits listed in the CMS file

DentalPreventive dental (cleanings, exams, x-rays)
Visionroutine eye exam; eyewear
Hearingroutine hearing exam; hearing aids, plan pays up to $1,500 every 2 years
Over-the-counter itemsAllowance offered (amount not listed in the CMS file)
TransportationRides to health-related locations
Home safetyHome and bathroom safety devices or modifications

Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.

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