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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 2026, 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 2026.
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 $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 $22.00 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) prescription drug plan features a low annual drug deductible of $22. Beneficiaries enjoy excellent savings on generic medications, with no copay for Tier 1 preferred generics and Tier 2 generics when using a standard pharmacy or standard mail order. This includes no copay for both 1-month and 3-month supplies of these generic drugs. For brand-name and specialty drugs, cost sharing is determined by coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance for both standard pharmacy and standard mail-order fills. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for 1-month supplies at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan offers robust coverage with no copays and no coinsurance for primary care visits, preventive services, and home health care. For more intensive medical care, members pay predictable copays with no coinsurance, such as a $295 daily copay for the first six days of inpatient hospital stays and a $150 copay for emergency room visits. Outpatient hospital services and diagnostic labs are also highly accessible, featuring no coinsurance and often no copays. Beyond basic medical care, this plan provides valuable everyday benefits, including routine dental, vision, and hearing exams with no copays. Members also benefit from no copays on over-the-counter items and up to 12 one-way transportation trips per year to plan-approved locations. Specialty needs like dialysis and durable medical equipment are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP) with no coinsurance, although prior authorization and referrals are required. Medicare-covered acute and psychiatric stays require a $295 daily copay for days 1 through 6 and no copay for days 7 through 90, but upgrades, non-Medicare-covered stays, and psychiatric stays beyond 90 days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP) with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital and observation services require a copay of up to $295 with no coinsurance, while outpatient substance abuse sessions range from no copay to a $25 copay with no coinsurance.
Partial Hospitalization See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this covered benefit.
Ambulance and Transportation Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) provides primary care physician visits, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, mental health, psychiatric, and physical, occupational, and speech therapy services are covered with no coinsurance and copays ranging from $0 to $25, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes training. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness, weight management, caregiver support, in-home support, and home safety devices. Sub-services that are not covered include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, alternative therapies, massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP), which offers one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation services are not covered. The plan also covers up to two OTC hearing aids per year with a $199 to $829 copay and no coinsurance, and up to two prescription hearing aids with a $199 to $1,249 copay and no coinsurance, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) partially covers vision services with no deductible and no coinsurance, offering no copay for annual routine eye exams and select eyewear, though eyeglass lenses carry a copay of $0 to $153. A $150 combined maximum benefit applies to eyewear every two years, while other eye exams, upgrades, and complete eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP) with no copay and no coinsurance for preventive care up to a $1,500 annual limit, while Medicare-covered services require no copay and 20% coinsurance, and comprehensive services require no copay and 50% coinsurance. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including insulin and chemotherapy, feature coinsurance ranging from no coinsurance to 20%, with insulin carrying a $35 copay.
Dialysis Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP) with no copay, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers diagnostic and radiological services, which require prior authorization and referrals. Diagnostic tests require a $50 copay and no coinsurance, lab services and diagnostic radiology have no copay and no coinsurance, outpatient X-rays carry a $25 copay and coinsurance, and therapeutic radiology requires a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the UHC Dual Complete TX-V007 (HMO-POS D-SNP) plan with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered by UHC Dual Complete TX-V007 (HMO-POS D-SNP), as intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization and referrals are required, and while a prior hospital stay is not necessary, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete TX-V007 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture, meal benefits, and highly integrated services are not covered.
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