Skip to main content
Medicare Advocates
Medicare Advantage · PFFS · Plan ID H5435-001-000

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS)

The UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) is a 2027 PFFS Medicare Advantage plan from UnitedHealthcare with a 2.5-star CMS rating. It may include allowances for vision, hearing, and part b giveback. It's available in 17 counties across 2 states.

Reviewed by the Medicare Advocates team · 2027 plan year · sourced from CMS data

Offered in 17 counties across 2 states

2027 plan at a glance
  • Monthly premiumVaries
  • Overall star rating2.5 / 5
  • In-network max out-of-pocket$6,700
Yearly benefit allowances
  • Vision$100
  • Hearing$750
  • Part B giveback$1,020

2027 plan-year figures (premium, star rating, MOOP) from the CMS Landscape file; allowance amounts from CMS PBP data. Amounts vary by plan; not all plans offer all benefits.

About this plan

UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS), plan H5435-001-000, is a 2027 Medicare Advantage plan from UnitedHealthcare, sold in Kansas. Its $6,700 in-network out-of-pocket limit is the lowest of the plans we compared in Cheyenne County.

How private fee-for-service works

A private fee-for-service plan works differently from a network plan. You can see any provider who accepts Medicare, as long as that provider agrees to the plan's terms and payment, and that agreement happens visit by visit. A provider who treated you last month can decline the next time, so it is worth confirming before each appointment rather than assuming.

In exchange you are not tied to a network or to referrals. Emergency care is covered wherever you are. Because the per-visit agreement is the part that surprises people, ask your regular doctors whether they will accept this type of plan before you enroll, not after.

Who can enroll

To join, you need Medicare Part A and Part B and you have to live in the plan's service area, which covers 17 counties in Kansas for 2027. You keep paying your Part B premium to Medicare.

Counties in the service area include Cheyenne, Decatur, Ellis, Lane, Logan and Rawlins.

Premium and giveback

This plan reduces your Part B premium, which people call a giveback. It is worth $1,020 over a year, about $85 a month, and it shows up as a lower Part B deduction rather than a payment to you.

What the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan may include

  • Vision: up to $100 per year in plan allowance (2027).
  • Hearing: up to $750 per year in plan allowance (2027).
  • Part B giveback: up to $1,020 per year in plan allowance (2027).

Costs & coverage detail

Doctor visits

  • Primary care visit$0–$20 copay
  • Specialist visit$0–$55 copay
  • Chiropractic (Medicare-covered)$15 copay
  • Podiatry (Medicare-covered)$45 copay

Emergency & urgent care

  • Emergency room$130 copay
  • Urgent care$0–$50 copay

Tests, labs & imaging

  • Lab services$0
  • Diagnostic tests & procedures$50 copay
  • X-rays$25 copay
  • Diagnostic radiology (CT/MRI/PET)$0–$260 copay

Outpatient hospital & surgery

  • Outpatient hospital services$0–$420 copay
  • Ambulatory surgical center$0–$420 copay
  • Outpatient substance abuse (individual)$0–$25 copay

Home health & equipment

  • Home health care$0

Medical equipment & supplies

  • Durable medical equipment (DME)20% coinsurance
  • Medical supplies (Medicare-covered)20% coinsurance
  • Part B drugs (other)0–20% coinsurance
  • Part B chemotherapy drugs0–20% coinsurance

Ambulance

  • Ground ambulance$290 copay

Dental

  • Preventive dental (exams, cleanings, X-rays)$0
  • Comprehensive dental (restorative)50% coinsurance

Vision

  • Routine eye exam$0
  • Eyewear (glasses/contacts)$0

Hearing

  • Routine hearing exam$20 copay
  • Hearing aids$0

Mental health

  • Mental health visit (individual)$0–$25 copay
  • Mental health visit (group)$15 copay
  • Psychiatric services (individual)$0–$25 copay
  • Inpatient psychiatric hospital$420/day, days 1–5; $0/day, days 6–90

Therapy

  • Occupational therapy visit$50 copay

Hospital stays

  • Inpatient hospital$420/day, days 1–5; $0/day, days 6–90
  • Skilled nursing facility (SNF)$0/day, days 1–20; $221/day, days 21–100

In-network, Medicare-covered cost sharing for the 2027 plan year (CMS PBP data). Costs vary by service and setting; see the Summary of Benefits for full detail.

Extra benefit allowances

  • Eyewear allowance$100 per year
  • Hearing aid allowance$1,500 every 2 years

What everyday care costs

With this plan, a primary care visit is $0 to $20, a specialist visit is $0 to $55, the emergency room is $130 and urgent care is $0 to $50. Emergency care and urgently needed services are covered whether or not the provider is in the plan's network, which matters when you are away from home.

An individual mental health visit is $0 to $25 and occupational therapy is $50.

Physical therapy and speech therapy are covered too, at cost shares the plan lists in its Summary of Benefits rather than in the CMS benefit files, so check those two there.

Preventive care and vaccines

You pay $0 for the preventive services Original Medicare covers when you use a provider in the plan's network. That includes your annual wellness visit, the recommended screenings for your age, and most vaccines. Preventive care is the easiest value to collect from any Medicare Advantage plan, so book the wellness visit early in the year.

Dental, vision and hearing

Beyond what Original Medicare covers, this plan includes $100 toward glasses or contacts and $1,500 toward hearing aids. These allowances almost always have to be used with providers and suppliers the plan works with, so check that before you buy, particularly for hearing aids where the plan usually names its own vendor.

The eyewear allowance covers eyeglasses or contact lenses, and it resets each plan year rather than rolling over, so an unused allowance is lost at the end of December.

Drug coverage: this plan does not include Part D

This plan does not include Part D prescription drug coverage. Most people who choose a plan like this already have drug coverage somewhere else, usually through the VA, TRICARE or a former employer, and that coverage is often creditable, which means keeping it protects you from a late enrollment penalty later.

If you do not have creditable drug coverage, that penalty is the thing to understand before you enroll: it is added to your Part D premium for as long as you have Part D, not just for one year. Whether you can add a separate drug plan while you are on this plan depends on the plan type, so have a licensed agent confirm it for this one rather than assuming.

Private fee-for-service plans are one of the shapes where adding a standalone drug plan is normally allowed, so that route is likely open here. Confirm it before you rely on it.

How this plan compares in Cheyenne County

Here is how UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) sits against other plans sold in Cheyenne County for 2027.

This plan has the lowest in-network out-of-pocket limit of the group at $6,700. UHC Dual Complete KS-QV1 (HMO-POS D-SNP) rates higher at 3.5 stars.

Who this plan may fit

This plan may fit people in the service area who want a lower ceiling on a bad year, which here is $6,700. It suits you if you would rather not be tied to a network, and less well if you want certainty that a given doctor will take the plan every time.

Like any Medicare Advantage plan, it changes how your Medicare claims are paid. If you travel often, or you want to use any doctor who accepts Medicare without checking a network, compare it against Original Medicare with a Medicare Supplement and a separate drug plan before you decide.

Questions to ask before you enroll

A licensed insurance agent can check all of these against your own doctors and prescriptions at no cost.

  • Are my doctors in the plan's network, and what would an out-of-network visit cost me?
  • Are all of my prescriptions on the plan's drug list, and at which tier?
  • When does the Part B giveback start, and how will I see it?
  • What counts toward the $6,700 out-of-pocket limit, and what does not?

Common questions

What is the UHC MedicareDirect Patriot No Rx PF-MA01 (PFFS) plan?
It is a Medicare Advantage plan (CMS plan ID H5435-001-000) offered by UnitedHealthcare for the 2027 plan year. Medicare Advantage plans bundle your Part A and Part B coverage, and most include extra benefits Original Medicare does not.
What extra benefits could this plan include?
Depending on the plan, supplemental benefits may include allowances toward vision, hearing, part b giveback. Amounts shown are for the 2027 plan year and vary by plan and area. A licensed agent can confirm what is available to you.
Where is this plan available?
For 2027, this plan is offered in 17 counties across 2 states. Availability and benefits depend on your specific ZIP code.
How do I enroll or compare plans?
Call to speak with a licensed insurance agent who can review this plan alongside the other options in your area at no cost. There is no obligation to enroll, and enrollment may be limited to certain times of year unless you qualify for a Special Enrollment Period.

Counties served

Kansas (8 counties)

Cheyenne, Decatur, Ellis, Lane, Logan, Rawlins, Scott, Thomas

Montana (9 counties)

Daniels, Fallon, Garfield, Petroleum, Phillips, Powder River, Prairie, Roosevelt, Valley

Ready when you are.

No cost. No pressure. There is no obligation to enroll.One licensed insurance agent, for as long as you’re on Medicare.