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UHC Complete Care CA-19P (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-19P (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-19P (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care CA-19P (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 Orange 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-19P (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-19P (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-19P (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-19P (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-19P (HMO-POS C-SNP) plan has a $255.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, if you go to a standard pharmacy, you will pay no copay for preferred generic drugs, $35.00 for standard generic drugs, and $100.00 for preferred brand drugs. Non-preferred drugs have a 30% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care CA-19P (HMO-POS C-SNP) plan offers comprehensive coverage with no copays for many services, including inpatient hospital stays, outpatient services, primary care, preventive services, and vision and dental exams. This plan also includes additional benefits such as ambulance and transportation services, emergency services, hearing services, and medical equipment, with varying copays or coinsurance depending on the specific service. This plan provides coverage for several services with no copay, such as home health, diagnostic and radiological services, and skilled nursing facilities. Additionally, there is coverage for services such as partial hospitalization, dialysis, and home infusion services. The plan also covers other services such as acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered with no copay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services have no copay, while outpatient substance abuse services have a copay between $0 and $25 for individual sessions, and a copay of $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered, requiring prior authorization and a doctor's referral. You will have a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including services not usually covered by Medicare plans, are covered. Ground and air ambulance services have a $150 copay, and transportation services to a plan-approved health-related location have no copay, with up to 48 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Complete Care CA-19P (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $20, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Complete Care CA-19P (HMO-POS C-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, 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. Primary care physician services have no copay, while individual and group mental health sessions have copays of $0-$25 and $15, respectively; routine foot care has no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered. Kidney Disease Education Services are covered, and require a doctor referral, with no copay.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are covered with no copay for one visit every year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids every year, while OTC hearing aids are covered with 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. Eye exams and routine eye exams have no copay, and eyewear has no copay, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Complete Care CA-19P (HMO-POS C-SNP) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Orthodontic services are covered, and other services, such as restorative services, may require prior authorization and have a $0 copay, but some services may have coinsurance up to 50%. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. 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 Complete Care CA-19P (HMO-POS C-SNP) plan, but require prior authorization and a doctor's referral. The coinsurance for this service is 20%.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetic devices, and medical supplies, is covered under the UHC Complete Care CA-19P (HMO-POS C-SNP) plan. Durable Medical Equipment has no copay and no coinsurance, while Durable Medical Equipment for use outside the home is not covered. Medicare-covered Prosthetic Devices, Medicare-covered Medical Supplies, Medicare-covered Diabetes Supplies, and Medicare-covered Diabetic Therapeutic Shoes or Inserts have no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor's referral and prior authorization required. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have no copay. Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care CA-19P (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 the specific services including Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered. A referral and prior authorization from your doctor are required to receive this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization and a doctor referral. For days 1-20, there is no copay, and for days 21-100, the copay is $100.
Other Services See details
Other Services include acupuncture and over-the-counter (OTC) items. Acupuncture has no copay, and is limited to 20 treatments per year. OTC items also have no copay, and include nicotine replacement therapy and Naloxone coverage. However, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
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