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UHC Complete Care TX-24 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care TX-24 (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 TX-24 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care TX-24 (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 Select Counties in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care TX-24 (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 TX-24 (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 TX-24 (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 TX-24 (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 $440.00 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 $4200.00 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 TX-24 (HMO-POS C-SNP) Medicare plan features an annual prescription drug deductible of $440. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled at standard pharmacies or through standard mail order. This provides a cost-effective option for individuals who primarily rely on generic maintenance medications. For brand-name and specialty prescriptions, costs are based on coinsurance percentages. Tier 3 preferred brand drugs require a 23% coinsurance, while Tier 4 non-preferred drugs carry a 44% coinsurance. Specialty medications in Tier 5 are covered with a 28% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The UHC Complete Care TX-24 (HMO-POS C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. For urgent needs, emergency room visits require a $150 copay, while inpatient hospital stays carry a $195 daily copay for the first six days and no copay thereafter up to 90 days. Most outpatient hospital services and specialist visits are also highly affordable, requiring no coinsurance and low to no copays. This plan also features strong ancillary benefits, including routine dental, vision, and hearing exams with no copay, plus a $300 eyewear allowance every two years. Members receive up to 24 one-way transportation trips to approved health locations with no copay and pay no copay or coinsurance for home health services and diabetic supplies. Other services like durable medical equipment and dialysis require no copay and a 20 percent coinsurance.
Inpatient Hospital See details
UHC Complete Care TX-24 (HMO-POS C-SNP) inpatient hospital services are partially covered with no coinsurance, requiring a $195 daily copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by UHC Complete Care TX-24 (HMO-POS C-SNP) with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services require a copay of $0 to $195, while outpatient substance abuse sessions carry a copay of $0 to $25.
Partial Hospitalization See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation benefits are partially covered, providing up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while trips to any other health-related locations are not covered.
Emergency Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from $0 to $65 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the UHC Complete Care TX-24 (HMO-POS C-SNP) plan feature no copay and no coinsurance for primary care provider visits and telehealth. Other covered services, including specialists, physical and occupational therapy, and mental health, have copays ranging from $0 to $25 with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Complete Care TX-24 (HMO-POS C-SNP) with no copay and no coinsurance for covered care such as annual physicals, fitness benefits, and safety devices. Services not covered under this benefit include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) hearing services are partially covered with no coinsurance, featuring one annual routine hearing exam with no copay, but fitting and evaluation exams are not covered. The plan covers up to two prescription hearing aids per year (with copays of $199 to $1,249 and no coinsurance) and two OTC hearing aids per year (with copays of $199 to $829 and no coinsurance), though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers vision services with no coinsurance, including one routine eye exam per year at no copay, while other eye exams are not covered. Covered eyewear has a $300 allowance every two years with no copay for contacts or frames and a $0 to $153 copay for lenses, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and 20% coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. However, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs require no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care TX-24 (HMO-POS C-SNP), featuring durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are also covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care TX-24 (HMO-POS C-SNP) with prior authorization and referrals required. Under this benefit, lab services and diagnostic radiology require no copay or coinsurance, diagnostic tests have a $50 copay with no coinsurance, outpatient X-rays carry a $25 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required for this benefit.
Cardiac Rehabilitation Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, although prior authorization and referrals are required. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
UHC Complete Care TX-24 (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization and referrals are required, but a prior three-day inpatient hospital stay is not, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Complete Care TX-24 (HMO-POS C-SNP) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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