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UHC Complete Care NV-4 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care NV-4 (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 NV-4 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care NV-4 (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 Clark and Nye Counties. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that UHC Complete Care NV-4 (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 NV-4 (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 NV-4 (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 NV-4 (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. Additionally, this plan comes with a Part B Premium reduction of $19.00. You must continue to pay paying your reduced 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 $900.00 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 NV-4 (HMO-POS C-SNP) plan has a $175 deductible for prescription drugs. After the deductible is met, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you'll pay an $8 copay for preferred generic drugs at a standard pharmacy, and $100 for preferred brand drugs. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care NV-4 (HMO-POS C-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services with no copay. It also includes coverage for primary care, preventive, hearing, vision, and dental services, often with no copays or low copays. Additionally, the plan covers ambulance services, emergency services, and transportation to health-related locations, with varying copays. This plan provides coverage for a wide range of services, such as home health, home infusion, and skilled nursing facility (SNF) care, with specific copays and coinsurance amounts. The plan also offers additional benefits like OTC items and meal benefits. However, it's important to note that certain services, such as cardiac rehabilitation and some specialized treatments, may not be covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, there is no copay for a Medicare-covered stay, and additional days for inpatient hospital acute have no copay. 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 are covered, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services. Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $15, and Group Sessions for Outpatient Substance Abuse have a $10 copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
The UHC Complete Care NV-4 (HMO-POS C-SNP) plan covers ambulance services with a $250 copay for both ground and air ambulance services, with no coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, up to 36 one-way trips per year, but transportation to any 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 NV-4 (HMO-POS C-SNP) plan. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $10; neither have coinsurance. Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
The UHC Complete Care NV-4 (HMO-POS C-SNP) plan covers Primary Care Physician Services, Chiropractic Services (with a $0 copay for routine care), Occupational Therapy Services (with a $0 copay), Physician Specialist Services (with no copay), Mental Health Specialty Services (with a copay of $0-$15 for individual sessions and $10 for group sessions), Podiatry Services (with a $0 copay for Medicare-covered services and routine foot care), Other Health Care Professional services (with no copay), Psychiatric Services (with a copay of $0-$15 for individual sessions and $10 for group sessions), Physical Therapy and Speech-Language Pathology Services (with no copay), Additional Telehealth Benefits (with no copay), and Opioid Treatment Program Services (with no copay). Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services like 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, and other services are not covered.
Hearing Services See details
Hearing services are covered by UHC Complete Care NV-4 (HMO-POS C-SNP), including hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829. Prescription hearing aids are covered with a copay between $199 and $1249, but fitting/evaluation for hearing aids, and prescription hearing aids (inner ear, outer ear, and over the ear) are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered annually with no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay, and a combined maximum plan benefit of $250 every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with no copay, other dental services, and orthodontic services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. Prosthodontics, removable and prosthodontics, fixed have a coinsurance between 0% and 50%. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Chemotherapy/Radiation Drugs, Other Medicare Part B Drugs, and Medicare Part B Insulin Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care NV-4 (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 by the UHC Complete Care NV-4 (HMO-POS C-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the UHC Complete Care NV-4 (HMO-POS C-SNP) plan. Diagnostic Procedures/Tests have no copay, while Lab Services also have no copay. Diagnostic Radiological Services have a copay of up to $150, Therapeutic Radiological Services have a copay of $25, and Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care NV-4 (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 NV-4 (HMO-POS C-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Complete Care NV-4 (HMO-POS C-SNP), with a $0 copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Under the UHC Complete Care NV-4 (HMO-POS C-SNP) plan, Over-the-Counter (OTC) Items and Meal Benefits are covered with no copay; however, acupuncture, 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.
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