UHC Nursing Home Plan NY-F001 (PPO I-SNP) H2292-001 • 2027 • Erie County, NY
- Monthly Premium
- $4.20Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Erie County, NY
- Local Enrollment
- 299 beneficiaries in Erie County
Introduction
CMS Plan ID H2292-001 identifies UHC Nursing Home Plan NY-F001, a Medicare Advantage Institutional Special Needs Plan (I-SNP) offered by UnitedHealthcare. Its provider network is a Preferred Provider Organization (PPO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $4.20 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.
Enrollment in this plan requires you to live in Erie County, New York. CMS reports 299 beneficiaries enrolled in this plan in Erie County. New members can call the plan directly at (888)834-3721 (TTY 711) for assistance.
Eligibility
UHC Nursing Home Plan NY-F001 is a Facility-based Institutional (FI-SNP) plan for individuals that require nursing care.
- Special Needs Plan Type
- Institutional Special Needs Plan (I-SNP)
- Medicare Requirement
- Must have Medicare Part A and Part B
- Special Needs Requirement
- This plan is for individuals living in a long-term care facility.
- 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 Erie County
Compare this plan with the most-enrolled other PPO I-SNP plan available in Erie County, New York. Enrollment is based on CMS local enrollment data.
| Plan Detail | UHC Nursing Home Plan NY-F001 | Aetna Medicare Longevity |
|---|---|---|
| CMS Plan ID | H2292-001-0 |
H5521-461-0 |
| Local Enrollment | 299 | 0 |
| Monthly Premium | $4.20 | $10.70 |
| Medical Deductible | Coming soon | Coming soon |
| Maximum Out-of-Pocket | $9,850.00 | $9,850.00 |
| Part B Giveback | Coming soon | Coming soon |
| Primary Care | Coming soon | Coming soon |
| Specialist | Coming soon | Coming soon |
| Part D Deductible | $700.00 | $700.00 |
| CMS Star Rating | 5.0 | 4.0 |
| Dental | Coming soon | Coming soon |
| Vision | Coming soon | Coming soon |
| Hearing | Coming soon | Coming soon |
Plan Benefits
UHC Nursing Home Plan NY-F001 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 H2292-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2292-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Specialist
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Telehealth benefit
- Not covered
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: 90% coinsurance - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0 copay
Out-of-network: 30% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: $0 copay - Outpatient x-rays
- In-network: $0 copay
Out-of-network: 30% coinsurance - Diagnostic tests and procedures
- In-network: $0 copay
Out-of-network: 30% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0-$40 copay
- Inpatient hospital care
- In-network:
Tier 1
$2,185 per stay
Out-of-network:
$2,185 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-100
Out-of-network:
30% per stay - Ground ambulance
- In-network: $0 copay
Out-of-network: $0 copay
Mental Health Services
- Outpatient individual therapy
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Outpatient group therapy
- In-network: 20% coinsurance
Out-of-network: 30% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$2,185 per stay
Out-of-network:
$2,185 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Occupational therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 20% coinsurance - Prosthetics
- In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 0%-30% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: $0 copay - Dental x-rays
- In-network: $0 copay
Out-of-network: $0 copay - Cleaning
- In-network: $0 copay
Out-of-network: $0 copay - 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
- In-network: $0 copay
Out-of-network: 30% coinsurance - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay - Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Fitting/evaluation
- Not covered
- Prescription hearing aids
- In-network: $0 copay
Out-of-network: $0 copay - OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- In-network: $0 copay
Out-of-network: 90% coinsurance
Certain preventive services are covered 100% by UHC Nursing Home Plan NY-F001 as a Part B benefit.
Prescription Drug Coverage
UHC Nursing Home Plan NY-F001 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: | $4.20 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $4.20 |
| Low-Income Premium Subsidy: | $40.45 |
| Low-Income Premium Subsidy Paid by CMS: | $4.20 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 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 Nursing Home Plan NY-F001 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 | Not available |
| Generic | $3.00 copay | Not available |
| Preferred Brand | 25% coinsurance | Not available |
| Non-Preferred Drug | 25% coinsurance | Not available |
| Specialty Tier | 25% coinsurance | Not available |
| Brand-name drugs | Not available | 25% coinsurance |
| Generic drugs | Not available | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H2292)
Medicare evaluates plan quality using a star rating system developed by the Centers for Medicare & Medicaid Services (CMS). Ratings are based on measures such as health outcomes, member experience, and customer service, and are reported on a 1 to 5 star scale, with higher ratings indicating stronger overall performance.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | Not enough data available |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
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
- (888)834-3721
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (888)834-3721
- 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/Medicare | October 4, 2026 |
| CMS.gov | Institutional Special Needs Plans (I-SNPs) | April 28, 2026 |
| Medicare.gov | Compare types of 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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