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UHC Dual Complete NE-S001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NE-S001 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Dual Complete NE-S001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete NE-S001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Nebraska. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete NE-S001 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Dual Complete NE-S001 (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Dual Complete NE-S001 (HMO-POS D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For UHC Dual Complete NE-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.50. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2,000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, you may have a reduced Part D premium. Once your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for Medicare Part D covered drugs, but you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including preventive services like annual physical exams, hearing aids, vision exams and eyewear, and home health services. Other services, such as outpatient services, primary care, and medical equipment, may have coinsurance requirements between 0% and 20%. The plan also covers specific services with copays, such as emergency services at $110 and partial hospitalization at $55. Ambulance and transportation services are covered with a 20% coinsurance, with transportation to health-related locations having no copay and limited to 36 one-way trips per year. Dental services are covered with 20% coinsurance, and prescription hearing aids have no copay up to $1500 per year.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute has no copay. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a coinsurance between 0% and 20%, observation services with a 20% coinsurance, and ambulatory surgical center services with a coinsurance between 0% and 20%. Outpatient substance abuse services are covered with a coinsurance between 0% and 20% for individual sessions and a 20% coinsurance for group sessions. Outpatient blood services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
The UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan covers ambulance and transportation services. Ground and air ambulance services have a 20% coinsurance, and transportation services to plan-approved health-related locations have no copay and are limited to 36 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan covers primary care physician services with a 0-20% coinsurance, chiropractic services with 20% coinsurance, and occupational therapy services with 0-20% coinsurance. Additionally, physician specialist services, mental health specialty services, psychiatric services, and physical therapy/speech-language pathology services are covered with a 0-20% coinsurance. The plan also covers podiatry services with 20% coinsurance and no copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive Services include annual physical exams with no copay, while additional preventive services like Fitness Benefits and Home and Bathroom Safety Devices and Modifications have no copay, and the plan covers services like Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas with no copay, but Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance. Some services, such as Health Education and Counseling Services, are not covered.
Hearing Services See details
The UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, and prescription hearing aids with no copay up to a maximum of $1500 per year. This plan also covers OTC hearing aids with no copay for a quantity of 2 per year. Fitting/evaluation for hearing aids, and prescription hearing aids for inner and outer ears are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and eyewear have no copay, and contact lenses, eyeglass lenses, and eyeglass frames also have no copay. Contact lenses are unlimited, while eyeglass lenses and frames are limited to one per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services, including Medicare dental services, are covered with 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NE-S001 (HMO-POS D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the following services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered. This plan requires prior authorization, and the copay is the same as original Medicare.
Other Services See details
Other services include Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, while meal benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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