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UHC Dual Complete CO-S4 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete CO-S4 (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 CO-S4 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete CO-S4 (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 State of Colorado. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete CO-S4 (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 CO-S4 (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 CO-S4 (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 CO-S4 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.50. 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 $615.00 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 $9250.00 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 CO-S4 (HMO-POS D-SNP) offers an Enhanced Alternative prescription drug benefit with an annual drug deductible of $615.00. During the initial coverage phase, you will typically pay a 25% coinsurance for Tier 1 through Tier 4 drugs at standard pharmacies and standard mail order services. This cost-sharing structure remains in place until your total drug costs reach $2,100.00. If you qualify for the Low-Income Subsidy, also known as Extra Help, your Part D premium can be reduced to $35.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescription drugs. This dual-eligible plan provides structured support to help manage your ongoing medication costs.
Additional Benefits
The UHC Dual Complete CO-S4 (HMO-POS D-SNP) plan offers comprehensive coverage for core medical needs with various cost-sharing options. Inpatient hospital stays require a $1,615 copay per stay with no coinsurance, while outpatient services, primary care, and specialist visits feature no copay and coinsurance ranging from 0% to 20%. Emergency care is subject to a $115 copay that is waived upon admission, while home health services feature no copay and no coinsurance. For supplemental care, the plan features dental and vision benefits with no copay and no coinsurance, subject to annual maximum allowances of $2,500 and $250 respectively. Members also benefit from routine hearing exams and hearing aids up to a $2,200 limit every two years with no copay. Furthermore, diabetic supplies, over-the-counter items, and chronic illness meals are covered with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) partially covers inpatient hospital services, requiring a $1,615 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Additional acute days are covered with no copay, but non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copays. Depending on the service, members will pay between no coinsurance and 20% coinsurance, and prior authorization is required for most of these benefits.
Partial Hospitalization See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), offering Medicare-approved ground and air ambulance services with a 20% coinsurance and no copay. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) covers emergency services with a $115 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a copay ranging from $0 to $40, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), as routine chiropractic care is not covered. Most services, including primary care and specialist visits, range from no coinsurance to 20% coinsurance, while telehealth and opioid treatment services have no copay.
Preventive Services See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) partially covers preventive services, offering annual physicals, fitness benefits, and glaucoma screenings with no copay and no coinsurance. While digital rectal exams and EKGs require a 20% coinsurance and no copay, other services like health education, medical nutrition therapy, and personal emergency response systems are not covered.
Hearing Services See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) partially covers hearing services, offering one annual routine hearing exam with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. The plan also covers up to two prescription or over-the-counter hearing aids every two years with no copay and no coinsurance up to a $2,200 limit, though inner ear, outer ear, and over-the-ear prescription models are excluded.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), offering routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames with no copay and no coinsurance, up to a $250 annual allowance. Upgrades and combined eyeglasses (lenses and frames) are not covered under this plan.
Dental Services See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) offers partially covered dental services with an annual maximum benefit of $2,500, excluding implant services and orthodontics which are not covered. Covered preventive and comprehensive services have no copay and no coinsurance, while Medicare-covered dental services require a 20% coinsurance and no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under UHC Dual Complete CO-S4 (HMO-POS D-SNP), subject to prior authorization. Medicare Part B Insulin Drugs require a $35 copay and no coinsurance to 20% coinsurance, while Part B chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), including durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts for a 20% coinsurance and no copay. Diabetic supplies are also covered with no copay and no coinsurance, though prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), with prior authorization required. Diagnostic lab services have no copay, while diagnostic procedures and tests require a copayment and 20% coinsurance. Radiological services, including outpatient X-rays, have no copay and carry a coinsurance of up to 20% (0% to 20% for diagnostic radiology).
Home Health Services See details
Home Health Services are covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Dual Complete CO-S4 (HMO-POS D-SNP) with coinsurance, no copay, and prior authorization required. While some services are covered, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete CO-S4 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with Medicare-defined copayments and coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. This benefit is partially covered, as additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete CO-S4 (HMO-POS D-SNP), which provides over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and dual eligible SNPs with highly integrated services are not covered under this benefit.
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