UnitedHealthcare MedicareDirect Patriot (PFFS)
Medicare Plan Details
2021 Plan
Monthly Premium
| (select county for price) |
by UnitedHealthcare
Additional Coverage
HearingVision
Overall Government Star Rating
3.0out of 5 stars
State: Montana
Select your county to view the price for this plan
Plan Type
Medicare Advantage (Part C)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B
Plan Details
Medical Benefits
Doctor Services
$25 copay per visit
$50 copay per visit
Tests, labs, & imaging
$25 copay
$0 copay
$0-150 copay
$15 copay
$90 copay per visit (always covered)
$40 copay per visit (always covered)
Hospital Services
$395 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 91 and beyond
$0 per day for days 5 through 90
$0 per day for days 91 and beyond
$0-395 copay per visit
Skilled nursing facility
$0 per day for days 1 through 20
$184 per day for days 21 through 57
$0 per day for days 58 through 100
$184 per day for days 21 through 57
$0 per day for days 58 through 100
Preventive services
$0 copay
Ambulance
$250 copay
Therapy services
$40 copay
$40 copay
Mental health services
$15 copay
$25 copay
$15 copay
$25 copay
Opioid treatment services
Covered
Other services
20% coinsurance per item
20% coinsurance per item
$0 copay per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
20% coinsurance
20% coinsurance
Extra Benefits
Hearing
$20 copay
Not covered
Not covered
Not covered
Not covered
Preventive Dental
Not covered
Not covered
Not covered
Not covered
Comprehensive dental
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Vision
$0 copay
Not covered
Not covered
Not covered
Not covered
Not covered
Other benefits
Not covered
Not covered
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Health Plan Star Ratings
(government star ratings are out of 5 stars)
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