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UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS)

Montana Medicare Advantage Plan (2025 Plan)

Monthly Premium

Your Cost
$0
by UnitedHealthcareⓇ

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 3.0
out of 5 stars

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Plan Overview

Plan Name
UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS)
Insurance Carrier
UnitedHealthcareⓇ
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
PFFS

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Montana and offered by the health insurance company UnitedHealthcareⓇ. This plan’s network type is PFFS which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$6,700
Primary doctor visit
$0-20 copay per visit
Specialist visit
$0-55 copay per visit
ER visit
$125 copay per visit (always covered)
Ambulance
$290 copay

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,700. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) are defined below.

Additional Benefits and Coverage

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Not covered
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) to Other Plans in Montana

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) received an overall government quality rating of 3.0 stars out of 5 stars.

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) performed worse than Montana’s State average overall quality score of 3.5 stars.

This Plan’s 5-star Gov’t Quality Score
Montana State Average Score
Overall Government 5 Star Quality Rating
 3.0
 3.5
Summary rating of health plan quality
 3
 3.5
Staying healthy: screenings, tests, & vaccines
 2
 3.4
Managing chronic (long term) conditions
 2
 3.0
Member experience with health plan
 3
 3.6
Member complaints & changes in the health plan's performance
 4
 4.2
Health plan customer service
 4
 4.1

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) received 3 stars for its health plan quality score which is worse than the Montana State average health plan quality score of 3.5 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$6,700
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://UHC.com/Medicare
Plan Link
http://UHC.com/Medicare

Medical Benefits

Doctor Services

Primary doctor visit
$0-20 copay per visit
Specialist visit
$0-55 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
$50 copay
Lab services
$0 copay
Diagnostic radiology services (like MRI)
$0-250 copay
Outpatient x-rays
$25 copay
Emergency care
$125 copay per visit (always covered)
Urgent care
$0-55 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
$420 per day for days 1 through 5
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
Outpatient hospital coverage
$0-420 copay per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$203 per day for days 21 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$290 copay

Therapy services

Occupational therapy visit
$0-45 copay
Physical therapy & speech & language therapy visit
$0-50 copay

Mental health services

Outpatient group therapy with a psychiatrist
$15 copay
Outpatient individual therapy with a psychiatrist
$0-25 copay
Outpatient group therapy visit
$15 copay
Outpatient individual therapy visit
$0-25 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
20% coinsurance per item
Prosthetics (like braces, artificial limbs)
20% coinsurance per item
Diabetes supplies
$0 copay per item

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Extra Benefits

Hearing

Hearing exam
$20 copay
Fitting/evaluation
Not covered
Hearing aids - All types
$0 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Prosthodontics, fixed
In-network: 0%-50% coinsurance
Out-of-network: 0%-50% coinsurance
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
Not covered
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
Not covered
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
Not covered

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