UHC One Care MA-Y3 (HMO D-SNP) H4610-001 • 2027 • Hampshire County, MA
- Monthly Premium
- $20.20Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $550.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Hampshire County, MA
- Local Enrollment
- 46 beneficiaries in Hampshire County
Introduction
CMS Plan ID H4610-001 identifies UHC One Care MA-Y3, a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by UnitedHealthcare. Its provider network is a Health Maintenance Organization (HMO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $20.20 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $550.00.
Enrollment in this plan requires you to live in Hampshire County, Massachusetts. CMS reports 46 beneficiaries enrolled in this plan in Hampshire County. New members can call the plan directly at (800)555-5757 (TTY 711) for assistance.
Eligibility
UHC One Care MA-Y3 is a Medicare D-SNP plan for people who qualify for both Medicare and Medicaid.
- Special Needs Plan Type
- Dual-Eligible Special Needs Plan (D-SNP)
- Medicare Requirement
- Medicare Part A and Part B
- Special Needs Requirement
- Must qualify for Medicaid
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Hampshire County
Compare this plan with the two most-enrolled HMO D-SNP plans available in Hampshire County, Massachusetts. Enrollment is based on CMS local enrollment data.
| Plan Detail | UHC One Care MA-Y3 | CCA One Care | CCA Senior Care Options |
|---|---|---|---|
| CMS Plan ID | H4610-001-0 |
H1486-001-0 |
H2225-001-0 |
| Local Enrollment | 46 | 693 | 491 |
| Monthly Premium | $20.20 | $33.80 | $33.80 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $8,390.00 | $9,850.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0 copay | $0 copay | $0 copay |
| Part D Deductible | $550.00 | $700.00 | $700.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | Not covered | Not covered | $0 copay |
| Vision | Not covered | Not covered | Not covered |
| Hearing | Not covered | Not covered | Not covered |
Plan Benefits
UHC One Care MA-Y3 has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H4610-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H4610-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0 copay
Preventive and Wellness Services
- Annual wellness exam
- Coming soon
- Telehealth benefit
- Coming soon
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Coming soon
- Counseling services
- Coming soon
- Over-the-counter drug benefits
- Coming soon
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $0 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- Tier 1
$0 per stay - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$0 per day for days 21-100 - Ground ambulance
- In-network: $0 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
- Outpatient group therapy
- In-network: $0 copay
- Inpatient psychiatric hospital care
- Tier 1
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: $0 copay
- Prosthetics
- In-network: $0 copay
Medicare Part B Drugs
- Chemotherapy
- In-network: $0 copay
- Other Part B drugs (Medicare-covered)
- In-network: $0 copay
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- Not covered
- Contact lenses
- Not covered
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- Not covered
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Coming soon
- Home-based palliative care
- Coming soon
- Personal emergency response system
- Coming soon
- Weight management programs
- Coming soon
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Coming soon
Certain preventive services are covered 100% by UHC One Care MA-Y3 as a Part B benefit.
Prescription Drug Coverage
UHC One Care MA-Y3 includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $20.20 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $20.20 |
| Low-Income Premium Subsidy: | $33.82 |
| Low-Income Premium Subsidy Paid by CMS: | $20.20 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $550.00 annual Part D deductible. You'll pay this deductible at the pharmacy before UnitedHealthcare starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, UHC One Care MA-Y3 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | $0.00 copay |
| Generic | $0.00 copay | $0.00 copay |
| Preferred Brand | 25% coinsurance | 25% coinsurance |
| Non-Preferred Drug | 25% coinsurance | 25% coinsurance |
| Specialty Tier | 27% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H4610)
Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | Plan too new to be measured |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
Contact Information for UnitedHealthcare
- Website
- UnitedHealthcare Plan Page
- Providers
- UnitedHealthcare Providers Page
- Formulary
- UnitedHealthcare Formulary Page
- Pharmacy
- UnitedHealthcare Pharmacy Page
- New Member Health Plan Help
- (800)555-5757
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (800)555-5757
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| UnitedHealthcare (official source) | http://UHC.com/CommunityPlan | October 4, 2026 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.