UHC Nursing Home Plan EX-F003 (PPO I-SNP) Medicare Special Need Plan H0710-026 • 2027
- Monthly Premium
- $18.10Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 7,443 beneficiaries
Introduction
CMS Plan ID H0710-026 identifies UHC Nursing Home Plan EX-F003, 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 $18.10 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 across the plan's service areas totals 7,443 beneficiaries, according to CMS. Enrollment is limited to beneficiaries who live within the plan's service area: See List.
Eligibility
UHC Nursing Home Plan EX-F003 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.
Plan Benefits
UHC Nursing Home Plan EX-F003 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 H0710-026.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
| Specialist | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: $0 copay |
| Telehealth benefit | Not covered | In-network: $0 copay |
| Routine chiropractic | Not covered | Not covered |
| Fitness benefits | Coming soon | Not covered |
| Health education | Not covered | Not covered |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | In-network: $0 copay Out-of-network: 90% coinsurance |
In-network: $0 copay Out-of-network: $0 copay |
| Health transportation (non-emergency) | Coming soon | In-network: $0 copay Out-of-network: 75% coinsurance |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
| Lab services | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Outpatient x-rays | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Diagnostic tests and procedures | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $115 copay | $115 copay |
| Worldwide emergency care | Coming soon | Not covered |
| Urgent care | $0-$40 copay | $0-$40 copay |
| Inpatient hospital care | In-network: Tier 1 $1,980 per stay Out-of-network: $1,980 per stay |
In-network: Tier 1 $2,135 per stay Out-of-network: $2,135 per stay |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-100 Out-of-network: 30% per stay |
In-network: Tier 1 $0 per day for days 1-100 Out-of-network: 30% per stay |
| Ground ambulance | In-network: 20% coinsurance Out-of-network: 20% coinsurance |
In-network: 20% coinsurance Out-of-network: 20% coinsurance |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
| Outpatient group therapy | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Inpatient psychiatric hospital care | In-network: Tier 1 $1,980 per stay Out-of-network: $1,980 per stay |
In-network: Tier 1 $2,135 per stay Out-of-network: $2,135 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Occupational therapy | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Durable medical equipment | In-network: 20% coinsurance Out-of-network: 30% coinsurance |
In-network: 20% coinsurance Out-of-network: 30% coinsurance |
| Prosthetics | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 30% coinsurance |
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 |
In-network: 0%-20% coinsurance Out-of-network: 0%-30% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Dental x-rays | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Cleaning | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Periodontics | Not covered | Not covered |
| Endodontics | Not covered | Not covered |
| Restorative services | Not covered | Not covered |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | Not covered | Not covered |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: $0 copay Out-of-network: 30% coinsurance |
| Contact lenses | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass frames only | Not covered | In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass lenses only | Not covered | In-network: $0 copay Out-of-network: $0 copay |
| Eyeglasses (frames & lenses) | In-network: $0 copay Out-of-network: $0 copay |
Not covered |
| Upgrades | Not covered | Not covered |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay Out-of-network: 30% coinsurance |
In-network: $0 copay Out-of-network: 30% coinsurance |
| Fitting/evaluation | Not covered | Not covered |
| Prescription hearing aids | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| OTC hearing aids | Not covered | In-network: $0 copay Out-of-network: $0 copay |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | Not covered |
| Alternative therapies | Not covered | Not covered |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | In-network: $0 copay Out-of-network: 90% coinsurance |
In-network: $0 copay Out-of-network: $0 copay |
Certain preventive services are covered 100% by UHC Nursing Home Plan EX-F003 as a Part B benefit.
Prescription Drug Coverage
UHC Nursing Home Plan EX-F003 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: | $18.10 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $18.10 |
| Low-Income Premium Subsidy: | $33.82 |
| Low-Income Premium Subsidy Paid by CMS: | $18.10 |
| 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 EX-F003 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | 25% coinsurance |
| Generic drugs | 25% coinsurance | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H0710)
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 | Not enough data available |
| 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.
Plan Availability
UHC Nursing Home Plan EX-F003 (H0710-026-0) is available in the following locations (click to open):
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
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 | 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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