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Physicians United Plan (PUP) Medicare Plans

Physicians United Plan HMO is a Coordinated Care Plan that has a URAC accreditation and a Medicare Advantage contract. Those who are eligible for this plan has both Medicare Part A and Part B and lives in selected counties in the state of Florida.Members must use in-network doctors, specialists and hospitals unless in extraordinary circumstances.The beneficiary is still responsible for his/her Part B deductible if a PUP Medicare Advantage plan is received. There are three Medicare Advantage groups which fall under the Physicians United Plan.They are the Medicare Advantage with Prescription Drug Plans, Medicare Advantage MA-only, and Medicare Advantage- Special Needs Plan.Look below to find your area:

Medicare Advantage with Prescription Drug Plans

Brevard, Manatee, Marion and Pasco Counties

PUP Easy

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $175 per day from days 1-8, and there is a $0 co-pay for days 9-90.There is a $175 per day for days 1-8 and a $0 co-pay per day for days 9-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $75 per day from days 1-39 in a skilled nursing facility and $0 per day from days 40-100.There is a $0 copay for each primary care doctor visit, $30 copay for each urgent care visit, and $25 copay for each specialist visit.

PUP Rewards

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.UP will also reduce the beneficiary's monthly Medicare Part B premium up to $50.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $290 per day from days 1-6, and there is a $0 co-pay for days 7-90.There is a $300 per day for days 1-6 and a $0 co-pay per day for days 7-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $100 per day from days 1-29 in a skilled nursing facility and $0 per day from days 30-100.There is a $10 copay for each primary care doctor visit, $30 copay for each urgent care visit, and $35 copay for each specialist visit.

Hillsborough, Lake, Orange, Osceola, Pinellas, Seminole and Sumter Counties

PUP Easy

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.  Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $80 per day from days 1-10, and there is a $0 co-pay for days 11-90. There is a $80 per day for days 1-10 and a $0 co-pay per day for days 11-90 in an inpatient mental care facility and members are given 190 days per lifetime. Members pay $75 per day from days 1-39 in a skilled nursing facility and $0 per day from days 40-100.There is a $0 copay for each primary care doctor visit, $25 copay for each urgent care visit, and $20 copay for each specialist visit.

PUP Rewards

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.PUP will also reduce the beneficiary's monthly Medicare Part B premium up to $67.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $225 per day from days 1-7, and there is a $0 co-pay for days 8-90.There is a $225 per day for days 1-7 and a $0 co-pay per day for days 8-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $75 per day from days 1-39 in a skilled nursing facility and $0 per day from days 40-100.There is a $5 copay for each primary care doctor visit, $30 copay for each urgent care visit, and $30 copay for each specialist visit.

Miami-Dade County

PUP Easy

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $0 copay and the plan covers a 90-day benefit period. There is $0 copay and members are given 190 days per lifetime for mental health facilities.Members pay $0 per day from days 1-10 in a skilled nursing facility and $25 per day from days 11-100.There is a $0 copay for each primary care doctor visit, urgent care visit, and specialist visit.

PUP Rewards

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.PUP will also reduce the beneficiary's monthly Medicare Part B premium up to $96.40.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $75 per day from days 1-7, and there is a $0 co-pay for days 8-90.There is a $75 per day for days 1-7 and a $0 co-pay per day for days 8-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $35 per day from days 1-100 in a skilled nursing facility. There is a $0 copay for each primary care doctor visit, $0 copay for each urgent care visit, and $5 copay for each specialist visit.

Broward and Palm Beach Counties

PUP Easy

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $50 per day from days 1-6, and there is a $0 co-pay for days 7-90.There is a $50 per day for days 1-6 and a $0 co-pay per day for days 7-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $0 per day from days 1-10 in a skilled nursing facility and $25 per day from days 11-100 There is a $0 copay for each primary care doctor visit, $5 copay for each urgent care visit, and $5 copay for each specialist visit.

PUP Rewards

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.PUP will also reduce the beneficiary's monthly Medicare Part B premium up to $96.40.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $125 per day from days 1-7, and there is a $0 co-pay for days 8-90.There is a $125 per day for days 1-7 and a $0 co-pay per day for days 8-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $35 per day from days 1-100.There is a $0 copay for each primary care doctor visit, $0 copay for each urgent care visit, and $20 copay for each specialist visit.

Polk County

PUP Easy

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $175 per day from days 1-5, and there is a $0 co-pay for days 6-90. There is a $175 per day for days 1-5 and a $0 co-pay per day for days 6-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $75 per day from days 1-39 in a skilled nursing facility and $0 per day from days 40-100.There is a $0 copay for each primary care doctor visit, $30 copay for each urgent care visit, and $25 copay for each specialist visit.

PUP Rewards

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.PUP will also reduce the beneficiary's monthly Medicare Part B premium up to $67.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $290 per day from days 1-6, and there is a $0 co-pay for days 7-90.There is a $300 per day for days 1-6 and a $0 copay per day for days 7-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $100 per day from days 1-29 and $0 per day from days 30-100.There is a $10 copay for each primary care doctor visit, $30 copay for each urgent care visit, and $35 copay for each specialist visit.

Medicare Advantage (MA-only)

Brevard, Broward, Hillsborough, Lake, Manatee, Marion, Miami Dade, Osceola, Orange,Palm Beach, Polk, Pasco, Pinellas, Sumter, and Seminole

PUP Perks

There is a $0 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.PUP will also reduce the beneficiary's monthly Medicare Part B premium up to $55. Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists.For hospital stays, members pay $250 per day from days 1-5, and there is a $0 co-pay for days 6-90.There is a $250 per day for days 1-5 and a $0 copay per day for days 6-90 in an inpatient mental care facility and members are given 190 days per lifetime.Members pay $50 per day from days 1-88 and $0 per day from days 89-100. There is a $10 copay for each primary care doctor visit, $35 copay for each urgent care visit, and $35 copay for each specialist visit.

Medicare Advantage Special Needs Plan

Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Polk and Seminole Counties

PUP Extra

There is a $20 monthly plan premium in addition to the beneficiary's monthly Medicare Part B premium.Members must go to in-network doctors, specialists and hospitals and referral is required for in-network specialists. For hospital stays, members pay $0 copay and the plan covers a 90-day benefit period.There is $0 copay and members are given 190 days per lifetime for mental health care facilities.Members pay $0 per day and there is a 100-day benefit period for skilled nursing facilities.There is a $0 copay for each primary care doctor visit, urgent care visit, and specialist visit.To receive the PUP Extra (HMO) plan, which is a Special Needs Plan, the beneficiary must have assistance from the state.