Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete TN-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 TN-S001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Unitedhealthcare Plan of the River Valley, Inc. available for the 2026 plan year to people living in State of Tennessee. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete TN-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 TN-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.
Below are a few key facts and commonly-asked questions about UHC Dual Complete TN-S001 (HMO-POS D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For UHC Dual Complete TN-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.10. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
The UHC Dual Complete TN-S001 (HMO-POS D-SNP) Medicare plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are available with no copay for both 1-month and 3-month supplies at standard pharmacies and standard mail order. For other drug tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance for a 1-month supply. Additionally, Tier 2 and Tier 3 medications maintain this 25% coinsurance for 3-month supplies through standard pharmacies and standard mail order.
The UHC Dual Complete TN-S001 (HMO-POS D-SNP) offers comprehensive medical coverage with many services featuring no copay. Inpatient hospital stays require a $1,675 copayment per stay with no coinsurance, while outpatient hospital services and primary care visits feature no copay and coinsurance ranging from 0% to 20%. Emergency room visits have a $115 copay, which is waived if you are admitted, and urgent care services range from no copay up to a $40 copay. This plan also provides robust supplemental benefits, including home health and skilled nursing facility care with no copay and no coinsurance. Preventive dental, routine vision, and annual hearing exams are covered with no copay and no coinsurance, though annual maximum limits apply, such as $3,000 for dental care and $2,500 for hearing aids every two years. Additionally, members can access up to 100 free one-way transportation trips per year and receive select medical equipment with no copay and a 20% coinsurance.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) inpatient hospital services are partially covered, requiring a $1,675 copayment per stay and no coinsurance for Medicare-covered acute and psychiatric stays, alongside no copay for additional acute days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers outpatient services with no copays. Outpatient hospital and ambulatory surgical center services have a 0% to 20% coinsurance, outpatient blood services require a 20% coinsurance, and outpatient substance abuse services feature no coinsurance.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers ambulance services with a 20% coinsurance and no copay, and partially covers transportation services with no copay or coinsurance. Covered transportation is limited to 100 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are provided with no copay and no coinsurance.
Primary care benefits for UHC Dual Complete TN-S001 (HMO-POS D-SNP) are covered with no copay and coinsurance ranging from 0% to 20% for physician and specialist visits. Physical, occupational, speech, and routine chiropractic therapies require a 20% coinsurance and no copay, while mental health, psychiatric, and telehealth services have no copay and no coinsurance. Chiropractic services are only partially covered, as other non-routine chiropractic services are not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) provides partially covered preventive services, featuring no copay and no coinsurance for annual physicals, kidney disease education, and fitness benefits, though digital rectal exams and post-welcome visit EKGs require a 20% coinsurance with no copay. Excluded sub-services that are not covered under this plan include health education, PERS, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) partially covers hearing services with no copay and no coinsurance for annual routine exams, OTC hearing aids, and up to two prescription hearing aids with a $2,500 maximum benefit every two years. However, fitting and evaluation services, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. Benefits include one routine eye exam and up to $300 yearly for contact lenses, eyeglass lenses, and frames, while other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) provides partially covered dental services with a $3,000 annual maximum, featuring no copay and no coinsurance for preventive and most comprehensive care, while Medicare-covered dental services require no copay and a 20% coinsurance. Implant services and orthodontics are not covered, and prior authorization is required for certain services.
Home infusion bundled services are covered by UHC Dual Complete TN-S001 (HMO-POS D-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy and other drugs have no copay and 0% to 20% coinsurance, while covered Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services are covered by UHC Dual Complete TN-S001 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical equipment is covered by UHC Dual Complete TN-S001 (HMO-POS D-SNP) with no copay for all items, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, and medical supplies. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, though prior authorization is required and manufacturer limitations apply.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures require a copay and 20% coinsurance, lab services have no copay but require coinsurance, and radiological services feature no copays, with coinsurance ranging from no coinsurance for diagnostic radiology to 20% for therapeutic and X-ray services.
Home health services are covered under the UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Prior authorization is required before you can receive these services.
Cardiac Rehabilitation Services are covered by UHC Dual Complete TN-S001 (HMO-POS D-SNP) with no copay, although prior authorization is required. However, some services are not covered, including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation, which all require a 20% coinsurance.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) care with no copay and no coinsurance, though prior authorization is required. The plan permits admission with less than a three-day prior inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
UHC Dual Complete TN-S001 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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