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UHC Complete Care CA-18P (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-18P (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-18P (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care CA-18P (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 Los Angeles 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-18P (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-18P (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-18P (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-18P (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 $255.00 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 $800.00 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-18P (HMO-POS C-SNP) plan has a $255 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay no copay for preferred generic drugs at a standard pharmacy. For standard generic drugs, you'll pay a $35 copay. For preferred brand drugs, the copay is $100. Non-preferred drugs have a 30% 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-18P (HMO-POS C-SNP) plan offers comprehensive coverage with no copays for many services, including inpatient hospital stays, outpatient services, primary care, preventive services, vision and dental exams, durable medical equipment, diagnostic services, and home health services. The plan also provides coverage for hearing services, prescription drugs, and various other services, often with copays or coinsurance. This plan has a $125 copay for emergency services, and $150 copay for ambulance services. Additionally, the plan covers skilled nursing facility services with no copay for the first 20 days, then a $100 copay for days 21-100. Some services, like partial hospitalization and dialysis services, require prior authorization.
Inpatient Hospital See details
The UHC Complete Care CA-18P (HMO-POS C-SNP) plan covers Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which have no copay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay, but non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, and ambulatory surgical center services have no copay. Individual outpatient substance abuse sessions have a copay between $0 and $25, and group sessions have a $15 copay. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care CA-18P (HMO-POS C-SNP) plan, with a $55 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Complete Care CA-18P (HMO-POS C-SNP) plan. Ground and air ambulance services have a $150 copay, while transportation services to a plan-approved health-related location have no copay for up to 48 one-way trips per year via taxi or medical transport, and transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Complete Care CA-18P (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $20. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Complete Care CA-18P (HMO-POS C-SNP) plan offers primary care services with no copay, chiropractic services with no copay, and occupational therapy services with no copay. It also covers physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services; however, some services may require a copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services, where the copay is specified elsewhere. Also covered are kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, all with 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 are covered, including hearing exams and prescription and OTC hearing aids. Routine hearing exams have no copay, and prescription hearing aids have a copay between $199 and $1249. OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, 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. There is no copay for eye exams, and routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $300 every two years, and contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare dental services with no copay, and other dental services with an annual maximum of $2500. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics, removable and fixed, have a coinsurance of 0-50%. Maxillofacial prosthetics have no copay. Implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Complete Care CA-18P (HMO-POS C-SNP). Medicare Part B Insulin Drugs have a $35 copay, and coinsurance between 0% and 20% applies for all other covered Medicare Part B drugs.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment is covered under this plan, including durable medical equipment (DME), prosthetics/medical supplies, and diabetic equipment. DME has no coinsurance and no copay. Prosthetic devices and medical supplies have no coinsurance and no copay. Diabetic supplies and therapeutic shoes/inserts have no coinsurance and 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 with no copay, Lab Services with no copay, Diagnostic Radiological Services with no copay, Therapeutic Radiological Services with a 20% coinsurance, and Outpatient X-Ray Services with no copay. All services require prior authorization and a doctor referral.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care CA-18P (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, but not in practice. Services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Complete Care CA-18P (HMO-POS C-SNP) with prior authorization and a doctor referral. For days 1-20, there is no copay, but for days 21-100, there is a $100 copay.
Other Services See details
Under "Other Services," the UHC Complete Care CA-18P (HMO-POS C-SNP) plan covers acupuncture with no copay, but is limited to 20 treatments per year, and also covers Over-the-Counter (OTC) items with no copay. However, the plan does not cover meal benefits, 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.
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