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UHC Dual Complete OH-S3 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete OH-S3 (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 OH-S3 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete OH-S3 (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 Ohio. The overall rating for this plan is not yet available for 2025.
It's important to know that UHC Dual Complete OH-S3 (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 OH-S3 (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 OH-S3 (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 OH-S3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.10. 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 $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 $9350.00 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 OH-S3 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, your monthly premium for Part D will be $39.30. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete OH-S3 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing. This plan includes coverage for inpatient and outpatient services, with copays and coinsurance applying to different services. It also provides coverage for emergency services, hearing, vision, and dental, with no copays for many of these services. Additional benefits include transportation, home health, and medical equipment. Many preventive services, such as annual physical exams, are covered with no copay. However, certain services like cardiac rehabilitation and skilled nursing facilities have limitations.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization; for Inpatient Hospital-Acute, the copay is $1500 per admission or stay and additional days have no copay, while Non-Medicare-covered Stay and Upgrades are not covered; for Inpatient Hospital Psychiatric, the copay is $1500 per admission or stay, and additional days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with 0% to 20% coinsurance, observation services with 20% coinsurance, ambulatory surgical center services with 0% to 20% coinsurance, outpatient substance abuse services with 0% to 20% coinsurance for individual sessions and 20% coinsurance for group sessions, and outpatient blood services with 20% coinsurance. This plan also includes an enhanced benefit of a waived three-pint deductible for outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance, and transportation services to plan-approved health-related locations with no copay. 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. For Emergency Services, there is a $110 copay, and for Urgently Needed Services, the copay is between $0 and $45; there is no coinsurance for either service. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered, with coinsurance ranging from 0% to 20% for many services. Chiropractic Services are partially covered, with a 20% coinsurance, while Routine Chiropractic Care is not covered; Podiatry Services are covered with Routine Foot Care subject to 20% coinsurance, and Routine Foot Care visits are limited to 8 per year; Additional Telehealth Benefits have no copay.
Preventive Services See details
The UHC Dual Complete OH-S3 (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, and Barium Enemas with no copay, while Digital Rectal Exams and EKG following Welcome Visit have 20% coinsurance.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Routine hearing exams have no copay and a coinsurance of 20%, while fitting/evaluation for hearing aids are not covered. Prescription hearing aids have no copay. OTC hearing aids are covered with no copay.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, including routine eye exams; however, eyewear coverage has a combined maximum of $350 per year, with no copay for contact lenses, eyeglass lenses, and eyeglass frames, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, but have varying limitations on the number of visits and periodicity. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OH-S3 (HMO-POS D-SNP) plan, but require prior authorization. This plan has a coinsurance of 20% for Dialysis Services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), is covered with a 20% coinsurance, and prior authorization is required. Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Equipment is covered with varying cost-sharing depending on the specific service.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at least 20%. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete OH-S3 (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 are not covered in practice. This plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not provide SNF services as a supplemental benefit under Part C. The plan requires prior authorization and charges the Medicare-defined cost share for tier 1; however, additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The UHC Dual Complete OH-S3 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. Over-the-Counter (OTC) Items have no copay, while Meal Benefits also have no copay and require prior authorization. Acupuncture, 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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