A non-government entity
UHC Complete Care CA-36P (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-36P (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-36P (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care CA-36P (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 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 CA-36P (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-36P (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-36P (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-36P (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 $3400.00 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:
Sign up for UHC Complete Care CA-36P (HMO-POS C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Complete Care CA-36P (HMO-POS C-SNP) plan has a $255 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for each prescription based on the drug tier and pharmacy you use. For example, you'll pay a $10 copay for a preferred generic drug at a standard pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The UHC Complete Care CA-36P (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays that vary by service. Emergency, primary care, and preventive services are covered with no copay, while hearing, vision, and dental services have no copays or coinsurance. This plan also includes coverage for ambulance services, and transportation to health-related locations, with copays. Additional benefits include home health services, medical equipment, and skilled nursing facilities, each with specific cost-sharing arrangements. Dialysis services, home infusion services, and diagnostic services are also covered, and may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the UHC Complete Care CA-36P (HMO-POS C-SNP) plan, but require prior authorization and a doctor's referral. For days 1-6, there is a $395 copay, and for days 7-90, there is no copay. Additional days for inpatient hospital-acute have no copay. Non-Medicare-covered stays and upgrades are not covered, 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 have a copay between $0 and $395, and Observation Services have a $395 copay. Ambulatory Surgical Center Services and Outpatient Blood Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, and Group Sessions for Outpatient Substance Abuse have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Complete Care CA-36P (HMO-POS C-SNP) plan. This benefit requires prior authorization and a doctor's referral, with a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $290 copay, and transportation services to a plan-approved health-related location with no copay, up to 36 one-way trips per year via taxi or medical transport. Transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $65. Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Under UHC Complete Care CA-36P (HMO-POS C-SNP), primary care physician services have no copay, chiropractic services have a $10 copay, and occupational therapy services have a copay between $0 and $10. Physician specialist services, mental health specialty services, podiatry services, and psychiatric services have varying copays, while other health care professional services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services have no copay.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Additional preventive services, like Fitness Benefit and Home and Bathroom Safety Devices and Modifications, are covered with a copay, while services like Health Education, In-Home Safety Assessment, and others are not covered. Kidney Disease Education Services, and Other Preventive Services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, and routine hearing exams are covered once per year. Prescription hearing aids have a copay between $199 and $1249 for all types, and 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
The UHC Complete Care CA-36P (HMO-POS C-SNP) plan covers vision services, including routine eye exams and eyewear. Eye exams and eyewear have no copay, and eyeglass lenses have a copay between $0 and $153. Eyeglass frames are covered, and contact lenses are covered. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance and other dental services with a $1,500 maximum per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services are covered with no copay; restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay and between 0% and 20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care CA-36P (HMO-POS C-SNP) plan, but require prior authorization and a doctor's referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while medical supplies and prosthetic devices have a 20% coinsurance, and diabetic supplies and therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization and a doctor referral required. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services have a copay of at most $125, Therapeutic Radiological Services have a copay of at least $80, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care CA-36P (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 not covered by the UHC Complete Care CA-36P (HMO-POS C-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, but acupuncture, 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 are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved