UHC Medicare Advantage TX-0030 (PPO) 2026 Plan Details for Duval County, Texas Residents
UHC Medicare Advantage TX-0030 (PPO) 2026 Plan Details for Duval County, Texas Residents
When selecting a Medicare Advantage plan in Duval County for 2026, it's important to compare all your options. UHC Medicare Advantage TX-0030 (PPO) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Based on the most recent CMS data, plan enrollments topped 18,175 members, with 38 in Duval County, Texas.
UHC Medicare Advantage TX-0030 Overview
| Plan ID R6801-012-0 Overview | |
|---|---|
| Health Plan ID: | R6801-012-0 |
| Medicare Advantage Plan Type: | Regional PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $102.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $8200.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Enhanced, $600.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Duval County, TX |
| Insured By: | UnitedHealthcare |
| We're Here to Help You Enroll |
|---|
Out-of-Pocket Costs
With UHC Medicare Advantage TX-0030, you'll have cost-sharing expenses, which are the out-of-pocket costs for approved healthcare services. The table below provides a summary of the typical in-network out-of-pocket costs associated with plan R6801-012-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0-$20 copay | Out-of-network: $30 copay |
| Specialist: | In-network: $0-$55 copay | Out-of-network: $55 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | Not covered |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | Not covered |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $115 copay |
| Wordwide emergency care: | $0 copay |
| Urgent care: | $0-$40 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $485 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $485 per day for days 1-5 | $0 per day for days 6-999 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | $0 per day for days 1-20 | $218 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $290 copay | Out-of-network: $290 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $0-$25 copay | Out-of-network: $25 copay |
| Outpatient group therapy: | In-network: $15 copay | Out-of-network: $15 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $485 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | $485 per day for days 1-5 | $0 per day for days 6-999 | $0 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $55 copay | Out-of-network: $55 copay |
| Occupational therapy: | In-network: $35 copay | Out-of-network: $35 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 50% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$260 copay | Out-of-network: $0-$260 copay |
| Lab services: | In-network: $0 copay | Out-of-network: $0 copay |
| Outpatient x-rays: | In-network: $30 copay | Out-of-network: $30 copay |
| Diagnostic tests and procedures: | In-network: $25 copay | Out-of-network: $25 copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | Not covered |
| Dental x-rays: | Not covered |
| Cleaning: | Not covered |
| Periodontics: | Not covered |
| Endodontics: | Not covered |
| Restorative services: | Not covered |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | Not covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $55 copay |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | In-network: $199-$1249 copay | Out-of-network: $199-$1249 copay |
| OTC hearing aids: | In-network: $199-$829 copay | Out-of-network: $199-$829 copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Contact lenses: | Not covered |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | Not covered |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by UHC Medicare Advantage TX-0030 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
UHC Medicare Advantage TX-0030 includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
| Basic Part D Premium: | $87.40 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $87.40 |
| Low-Income Premium Subsidy: | $4.82 |
| Low-Income Premium Subsidy Paid by CMS: | $4.80 |
| Low-Income Subsidy Premium: | $82.60 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $600.00 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 Medicare Advantage TX-0030 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 | Coming soon |
| Generic | $14.00 copay | Coming soon |
| Preferred Brand | 18% coinsurance | Coming soon |
| Non-Preferred Drug | 27% coinsurance | Coming soon |
| Specialty Tier | 26% coinsurance | Coming soon |
| *Deductible does not apply. | ||
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| 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 | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Who Can Enroll in UHC Medicare Advantage TX-0030?
To enroll in UHC Medicare Advantage TX-0030, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in UHC Medicare Advantage TX-0030 and benefit from its comprehensive coverage options.
When Can I Enroll in UHC Medicare Advantage TX-0030?
To ensure you don’t miss your chance to enroll in UHC Medicare Advantage TX-0030, be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
How to Sign Up for UHC Medicare Advantage TX-0030
Enrolling in UHC Medicare Advantage TX-0030 is easy. Choose the option that works best for you:
- Online through MedicareEnrollment.com: Visit the enrollment page and complete your enrollment through their Secure Online Enrollment Form.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent can assist you with the enrollment process and provide answers to any questions.
- Through Medicare.gov: Go to Medicare.gov, log in or create an account, and follow the instructions to join UHC Medicare Advantage TX-0030 through the official Medicare website.
- Directly with UHC Medicare Advantage TX-0030: You can also enroll directly with the plan. The necessary contact details are provided below in the "Contact" section.
Remember to enroll during the correct enrollment period to ensure your coverage starts on time.
Here are some of the most frequently asked questions people have about plan ID R6801-012-0:
How much does R6801-012-0 cost per month?
Members pay their Part B premium and the plan's of $102.00 per month to be in this 2026 plan.
What is the annual out-of-pocket maximum on this plan?
Your costs top out at $8200.00 (for in-network services) in 2026; after that the plan pays 100% of covered services.
Is there a Part D deductible with this plan?
You’ll pay the first $600.00 in drug costs before coinsurance kicks in.
How is this plan rated by Medicare?
For 2026, plan R6801-012-0 has a ★3.5 rating. The best rating is 5 stars.
Is UHC Medicare Advantage TX-0030 popular?
Enrollment stands at roughly 18,175 members.
Contact UnitedHealthcare
| Contact Type | Details |
|---|---|
| Website: | UnitedHealthcare Plan Page |
| New Members: | 1-800-555-5757 |
| Existing Members: | 1-866-550-4736 |
| Plan Address: | P.O. Box 30770 | Salt Lake City, UT 84130 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- UnitedHealthcare, http://UHC.com/Medicare — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
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Page content managed by David Bynon, Medicare Analyst.
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