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UHC Dual Complete TX-V007 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete TX-V007 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Dual Complete TX-V007 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-V007 (HMO-POS D-SNP) is a HMO-POS D-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 2025.
It's important to know that UHC Dual Complete TX-V007 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Dual Complete TX-V007 (HMO-POS D-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 Dual Complete TX-V007 (HMO-POS D-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 Dual Complete TX-V007 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.00. 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 $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 $3900.00 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 Dual Complete TX-V007 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, the plan covers the cost of drugs. If you qualify for the low-income subsidy, you will pay $3.00 for each prescription. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan offers a variety of benefits with varying costs. Many services have no copay, including primary care visits, preventive services like annual physicals, hearing exams, eye exams, dental cleanings, and home health services. Other services, such as inpatient hospital stays, have copays, and some services require coinsurance. This plan includes coverage for emergency services, outpatient services, and prescription hearing aids with copays. It also covers services like ambulance, dental, vision, and home infusion with copays or coinsurance. The plan has some limitations, such as coverage for only a limited number of transportation trips per year, and requires prior authorization for certain services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered under this plan. For days 1-5, there is a $250 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $0-$250, observation services with a $250 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have copays ranging from $0-$25 for individual sessions and $15 for group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Both ground and air ambulance services have a $275 copay, while transportation services to plan-approved health-related locations have no copay, with a limit of 12 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $65. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services have a copay between $0 and $20, and physician specialist services have a copay between $0 and $20. Mental health and psychiatric services, as well as other health care professional services, have a variable copay depending on the service. Physical therapy and speech-language pathology services have a copay between $0 and $20. Additional telehealth benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
The UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services include Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing Services include coverage for hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829, but fitting/evaluation for hearing aids, and prescription hearing aids (inner ear, outer ear, and over the ear) are not covered. Prescription hearing aids (all types) are covered with a copay between $199 and $1249.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, as well as oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and prosthodontics (removable and fixed) are covered with no copay and require prior authorization. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. 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 under the UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
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 Prosthetic Devices and Medical Supplies also 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, with prior authorization and a doctor's referral required. Diagnostic Procedures/Tests have a $15 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $225, and Therapeutic Radiological Services have 20% coinsurance. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TX-V007 (HMO-POS D-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 plan does not cover the sub-services of 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. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan, with a doctor referral and prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; there is no coinsurance. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan's other services include over-the-counter 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.
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