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UHC Complete Care CA-15P (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care CA-15P (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care CA-15P (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care CA-15P (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Diego County. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Complete Care CA-15P (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care CA-15P (HMO-POS C-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 Complete Care CA-15P (HMO-POS C-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 Complete Care CA-15P (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $175.00 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 $2900.00 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 Complete Care CA-15P (HMO-POS C-SNP) plan has a $175 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay no copay for preferred generic drugs at standard pharmacies, while you'll pay a $47 copay for standard generic drugs. For preferred brand drugs, you'll pay a $100 copay at standard and mail order pharmacies. For non-preferred drugs, you'll pay 31% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care CA-15P (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including primary care visits, preventive services like annual physical exams, hearing and vision exams, dental cleanings, and home health services. Other services, such as inpatient hospital stays, outpatient services, and emergency services, have copays ranging from $0 to $275. The plan also provides coverage for hearing aids, eyewear, and some medical equipment, often with copays or coinsurance. Additional benefits include acupuncture, over-the-counter items, and a meal benefit, all with no copay.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered with a $225 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay for days 91-999, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $100, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization and a doctor referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $275 copay, and transportation services to a plan-approved health-related location with no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Complete Care CA-15P (HMO-POS C-SNP) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $30; both have no coinsurance. Worldwide Emergency, Urgent, and Transportation services have no copay and no coinsurance.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with no copay, Chiropractic Services with no copay, Occupational Therapy Services with a copay between $0 and $35, Physician Specialist Services with no copay, Mental Health Specialty Services with a copay up to $25 for individual sessions and $15 for group sessions, Podiatry Services with no copay, Other Health Care Professional with no copay, Psychiatric Services with a copay up to $25 for individual sessions and $15 for group sessions, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $35, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, additional preventive services, kidney disease education services, and other preventive services. Annual physical exams have no copay, while additional services like fitness benefit, home and bathroom safety devices, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit have no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, and routine hearing exams have no copay. Prescription hearing aids have a copay between $199 and $1249 depending on the type of hearing aid, and OTC hearing aids have a copay between $99 and $829. 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 with UHC Complete Care CA-15P (HMO-POS C-SNP) includes eye exams with no copay, and eyewear with no copay; however, eyeglass lenses have a copay of $0-$153.00. Eyeglass frames and contact lenses are covered with no copay, and the plan offers a combined maximum of $300.00 every two years for eyewear.
Dental Services See details
Dental Services include no copay for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, 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%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care CA-15P (HMO-POS C-SNP) plan, requiring prior authorization and a doctor referral. There is no copay for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 10% coinsurance, Prosthetics/Medical Supplies - Non-Medicare benefits with 10% coinsurance, and Diabetic Equipment. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services have a copay of at most $95.00, and Outpatient X-Ray Services have a $10 copay; Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care CA-15P (HMO-POS C-SNP) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Complete Care CA-15P (HMO-POS C-SNP), but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Complete Care CA-15P (HMO-POS C-SNP), with no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture has no copay and is limited to 12 treatments per year. OTC items have no copay and include nicotine replacement therapy and Naloxone. The meal benefit also has no copay and is for a chronic illness. Additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and Case Management are not covered.
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