UHC Nursing Home Plan FL-F002 (PPO I-SNP)

CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. · 2026 plan year

Plan ID H0710-038-000

Local PPO★ 4.5 CMS StarsInstitutional SNP
MOOP (in-network)
$9,250
MOOP (combined)
$13,900
Monthly premium
$4.80/mo
Part C $0 + Part D $4.80, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H0710-038-000
Medical deductible
$0 — no deductible
Part D premium
$4.80/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$615/yr
Also owed
Your Medicare Part B premium, paid separately

More CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. plans in FL

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$2,000 per stay
Inpatient Hospital — Psychiatric$2,000 per stay

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions0%-20% coinsurance
Mental Health — Group Sessions20% coinsurance
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Diabetic Supplies20% coinsurance
Ambulance ServicesSee plan details
Skilled Nursing Facility (SNF)No charge
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions20% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions20% coinsurance
Pulmonary Rehabilitation — Additional Sessions20% coinsurance
Supervised Exercise Therapy (SET)20% coinsurance
Emergency Services$115
Urgently Needed Services$0-$40
Partial Hospitalization ProgramNo charge
Intensive Outpatient Program (IOP)No charge
Home Health ServicesNo charge
Primary Care Physician Services0%-20% coinsurance
Chiropractic Services20% coinsurance
Occupational Therapy Services20% coinsurance
Physician Specialist Services0%-20% coinsurance
Vision — EyewearSee plan details
Podiatry Services20% coinsurance
Podiatry ServicesNo charge
Other Health Care Professional Services0%-20% coinsurance
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions0%-20% coinsurance
Psychiatric Services — Group Sessions20% coinsurance
Physical Therapy & Speech-Language Pathology20% coinsurance
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology0%-20% coinsurance
Therapeutic RadiologyNo charge
X-Ray ServicesNo charge
Outpatient Hospital Services0%-20% coinsurance
Hospital Observation Services20% coinsurance
Ambulatory Surgical Center (ASC)0%-20% coinsurance
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions0%-20% coinsurance
Substance Abuse — Group Sessions20% coinsurance
Outpatient Blood Services20% coinsurance
Ground Ambulance20% coinsurance
Air Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices0%-20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Home & Bathroom Safety DevicesNo charge
Kidney Disease Education ServicesNo charge
Glaucoma Screening20% coinsurance
Diabetes Self-Management TrainingNo charge
Digital Rectal Exams20% coinsurance
Welcome to Medicare EKG20% coinsurance
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services20% coinsurance
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Vision — Eye Exams20% coinsurance
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — Contact LensesNo charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams20% coinsurance
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Hearing — OTC Hearing AidsNo charge

Service area

  • FL: 1 county

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