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UHC Dual Complete RI-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete RI-S001 (PPO 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 RI-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete RI-S001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Rhode Island. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete RI-S001 (PPO 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 RI-S001 (PPO 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 RI-S001 (PPO 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 RI-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.60. 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 $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 combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 RI-S001 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are fully covered with no copay for 1-month and 3-month supplies at standard pharmacies, as well as 3-month standard mail order fills. This ensures that essential everyday medications remain highly accessible and affordable for members. For Tier 2 generic drugs, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance rate applies to standard retail pharmacy and standard mail order fills, depending on the tier and supply duration. This straightforward cost-sharing structure helps you easily project your out-of-pocket prescription costs.
Additional Benefits
The UHC Dual Complete RI-S001 (PPO D-SNP) plan offers comprehensive medical coverage with no copay for primary care, specialist, and preventive services, though a coinsurance of up to 20% may apply to some visits. Inpatient hospital stays require a $1,925 copay per admission with no coinsurance, while emergency room visits carry a $115 copay. Outpatient services, home health, and skilled nursing facility care are covered with no copay, although some outpatient procedures and durable medical equipment carry a 20% coinsurance. This plan also features robust everyday care benefits, including routine dental, vision, and hearing services with no copays and generous allowances, such as a $2,000 dental limit and a $200 eyewear allowance. Additionally, members benefit from covered over-the-counter items, home meal benefits, and up to 24 routine transportation trips per year with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,925 copayment per admission and no coinsurance. While unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete RI-S001 (PPO D-SNP) with no copay, though coinsurance applies to several services. Outpatient hospital, ambulatory surgical center, and individual substance abuse sessions have no coinsurance to 20% coinsurance, while observation, group substance abuse, and blood services carry a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete RI-S001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $40 copay 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 UHC Dual Complete RI-S001 (PPO D-SNP) are covered with no copay and 0% to 20% coinsurance for primary care, specialist, and mental health services. Physical, occupational, and speech therapies require no copay and 20% coinsurance, telehealth and opioid treatments have no copay and no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete RI-S001 (PPO D-SNP), featuring no copay and no coinsurance for annual physicals, fitness benefits, and kidney disease education. While most covered services have no copay or coinsurance, digital rectal exams and post-welcome visit EKGs require a 20% coinsurance. Non-covered services include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) provides partially covered hearing services, which include one routine exam per year with no copay and a 20% coinsurance, but exclude hearing aid fittings and evaluations. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $2,200 maximum limit every two years, though inner ear, outer ear, and over-the-ear models are not covered. Up to two OTC hearing aids are also covered every two years with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Dual Complete RI-S001 (PPO D-SNP) with no copay, no coinsurance, and no deductible. The plan covers one routine eye exam per year (requires prior authorization) and provides a $200 annual limit for contact lenses, eyeglass lenses, and eyeglass frames, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete RI-S001 (PPO D-SNP), offering preventive and comprehensive care with no copay and no coinsurance up to a $2,000 annual maximum, though implant services and orthodontics are not covered. Medicare-covered dental services are also available with no copay and a 20% coinsurance, with prior authorization required for some treatments.
Home Infusion bundled Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by UHC Dual Complete RI-S001 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required before receiving these services.
Medical Equipment See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures and tests require a copay and 20% coinsurance, lab services have no copay but require coinsurance, and diagnostic radiological services have no copay and no coinsurance. Therapeutic radiological and outpatient X-ray services require a 20% coinsurance and no copay.
Home Health Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by UHC Dual Complete RI-S001 (PPO D-SNP) with no copay and require prior authorization. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete RI-S001 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered. This benefit does not require a prior three-day inpatient hospital stay for admission.
Other Services See details
UHC Dual Complete RI-S001 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance, though meal benefits require prior authorization. Acupuncture is not covered under this plan.
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