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UHC Complete Care Support CA-7AP (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care Support CA-7AP (HMO 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 Support CA-7AP (HMO C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care Support CA-7AP (HMO C-SNP) is a HMO C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Luis Obispo County. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Complete Care Support CA-7AP (HMO 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 Support CA-7AP (HMO 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 Support CA-7AP (HMO 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 Support CA-7AP (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.70. 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 $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 Complete Care Support CA-7AP (HMO C-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, your costs will vary depending on the drug tier and pharmacy. The plan's premium may be reduced if you qualify for the low-income subsidy, with a Part D premium of $29.70. Once your total drug costs reach $2,000, you enter the Catastrophic Coverage Phase where you pay nothing for covered drugs. This plan is a defined standard plan.
Additional Benefits
The UHC Complete Care Support CA-7AP (HMO C-SNP) plan offers a range of benefits with varying cost-sharing structures. Inpatient hospital stays have a $1295 copay per admission, with additional days having no copay. Outpatient services and primary care visits often have coinsurance, while many preventive services, such as an annual physical exam, are covered with no copay. The plan provides coverage for hearing and vision services, including routine exams and eyewear with no copay. Dental services include preventive care with no copay, and other services may have coinsurance. Additionally, the plan covers ambulance, home health, and diagnostic services, with the potential for coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization and a doctor referral. For Inpatient Hospital-Acute, you pay a copay of $1295 per admission or stay, while additional days for Inpatient Hospital-Acute have no copay. 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 also not covered.
Outpatient Services See details
Outpatient hospital services, including observation services, have a coinsurance of 0% to 20%, while ambulatory surgical center services and outpatient substance abuse services have varying coinsurance. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care Support CA-7AP (HMO C-SNP) plan, 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 both ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Ground and air ambulance services have a 20% coinsurance, while transportation services to plan-approved health-related locations have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by UHC Complete Care Support CA-7AP (HMO C-SNP) with a $110 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Complete Care Support CA-7AP (HMO C-SNP) plan covers primary care physician services with a coinsurance of 0% to 20%, and also covers routine chiropractic care with no copay and 20 visits per year. Occupational therapy services have a coinsurance of 0% to 20%, and individual and group sessions for mental health services have coinsurance between 0% and 20%. Additionally, the plan covers telehealth with no copay.
Preventive Services See details
The UHC Complete Care Support CA-7AP (HMO C-SNP) plan covers preventive services, including an annual physical exam with no copay. The plan also covers additional preventive services, and other services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit with no copay. However, services like health education, in-home safety assessment, and others are not covered.
Hearing Services See details
Hearing services include routine hearing exams with 20% coinsurance, prescription hearing aids (all types) with no copay, and OTC 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, with no copay for eye exams, contact lenses, eyeglass lenses, and eyeglass frames. Routine eye exams are limited to one per year. Eyewear has a combined maximum benefit of $300 per year, while eyeglass lenses and frames are limited to one per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services under the UHC Complete Care Support CA-7AP (HMO C-SNP) plan include coverage for Medicare dental services with a 20% coinsurance after prior authorization and a doctor referral. Other dental services include oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. However, orthodontic, restorative, adjunctive general, endodontic, periodontic, prosthodontic, maxillofacial prosthetics, implant, prosthodontic (fixed), oral and maxillofacial surgery, and orthodontics services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UHC Complete Care Support CA-7AP (HMO C-SNP) plan. 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, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with no copay, lab services with no copay, and radiological services with a coinsurance of at most 20%. The coinsurance for diagnostic radiological services is at most 20%, therapeutic radiological services is at least 20%, and outpatient X-ray services is at least 20%.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care Support CA-7AP (HMO 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 not covered by the UHC Complete Care Support CA-7AP (HMO C-SNP) plan. While the plan covers some cardiac rehabilitation services, it does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, or SET for PAD Services.
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 or non-Medicare-covered SNF stays. Prior authorization and a doctor referral are required, and the copay information is available in the plan details.
Other Services See details
The "Other Services" benefit in the UHC Complete Care Support CA-7AP (HMO C-SNP) plan covers acupuncture with no copay for up to 20 treatments per year, and also covers over-the-counter items with no copay, including nicotine replacement therapy and naloxone. Meal benefits, dual eligible SNPs with highly integrated services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
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