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UHC Dual Complete TN-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 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 2025, please refer to our full plan details page.
UHC Dual Complete TN-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 State of Tennessee. This plan received an overall rating of 4 out of 5 stars in 2025.
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.
Key Plan Facts
Below are a few key facts and commonly-asked questions about UHC Dual Complete TN-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 TN-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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 TN-S001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay costs for drugs based on the tier and pharmacy type until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), you will pay $40 for Part D drugs. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for covered Part D drugs.
Additional Benefits
The UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing. It covers inpatient hospital stays with a $1,530 copay, outpatient services with a 0-20% coinsurance, and emergency services with a $110 copay. The plan also includes coverage for primary care, hearing, vision, and dental services, often with no copay or a 20% coinsurance, and provides home health and home infusion services. Additional benefits include transportation to health-related locations with no copay, prescription hearing aids, and an annual eyewear benefit. The plan covers various preventive services with no copay, as well as medical equipment and diagnostic services with coinsurance. However, some services such as additional days for inpatient care, implant services, and orthodontics are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $1,530 per admission or stay. Additional Days for Inpatient Hospital-Acute has no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a 0% to 20% coinsurance, observation services with a 20% coinsurance, and ambulatory surgical center services with 0% to 20% coinsurance. Outpatient Substance Abuse Services include no copay for individual and group sessions, and Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, both with a 20% coinsurance, and transportation services to plan-approved health-related locations with no copay, up to 100 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $110 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services are covered, with no copay or coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan covers primary care physician services with a 0-20% coinsurance, chiropractic services with a 20% coinsurance and no copay for routine care, and occupational therapy services with a 0-20% coinsurance and no copay. The plan also covers physician specialist services with a 0-20% coinsurance, mental health specialty services and psychiatric services with no copay for individual and group sessions, and podiatry services with a 20% coinsurance and no copay for routine foot care. Additionally, other health care professional services are covered with a 0-20% coinsurance, physical therapy and speech-language pathology services with a 0-20% 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 Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with varying copays. Other preventive services include glaucoma screenings, diabetes self-management training, and barium enemas with no copay, and digital rectal exams and EKGs following a welcome visit with 20% coinsurance. Some services, such as Health Education, are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with no copay, and prescription hearing aids with a maximum benefit of $3200 per year, and over-the-counter hearing aids with no copay. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear coverage. Eye exams have no copay, and routine eye exams are covered with no copay. Eyewear has no copay, and there is a combined maximum plan benefit coverage amount of $600 per year.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. 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), maxillofacial prosthetics, prosthodontics (fixed), 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, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan. This plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, and Diabetic Equipment are covered. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of up to 20% and no copay, Therapeutic Radiological Services and Outpatient X-Ray Services with a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
The UHC Dual Complete TN-S001 (HMO-POS D-SNP) plan covers 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, 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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