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UHC Dual Complete NV-S001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NV-S001 (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 NV-S001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete NV-S001 (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 Clark, Nye and Washoe Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete NV-S001 (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 NV-S001 (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 NV-S001 (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 NV-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $12.60. 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 $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 NV-S001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, you will pay the costs for your 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 (LIS), your monthly premium will be $12.60. 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 NV-S001 (HMO-POS D-SNP) plan offers a variety of benefits to help cover your healthcare needs. Inpatient hospital stays have a $2000 copay per admission, while outpatient services and primary care have varying coinsurance. Emergency services have a $110 copay, and ambulance services have a 20% coinsurance. Additional benefits of this plan include no copay for preventive services like annual physical exams, fitness benefits, home and bathroom safety devices, and hearing exams, hearing aids, and vision services. You'll also find no copay for dental services, home health services, OTC items, and meal benefits. The plan also offers additional benefits like transportation services, and no copay for telehealth benefits.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered by the UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan, but require prior authorization and a doctor referral. For acute inpatient hospital stays, there is a $2000 copay per admission or stay. Additional days for acute inpatient hospital stays have no copay. Non-Medicare-covered stays and upgrades for acute inpatient hospital, as well as additional days and non-Medicare-covered stays for psychiatric inpatient hospital, are not covered.
Outpatient Services See details
Outpatient services, including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient substance abuse services, are covered. Outpatient hospital services have a coinsurance of 0% to 20%, observation services have a 20% coinsurance, and outpatient blood services have a 20% coinsurance, while outpatient substance abuse services (individual sessions) have a coinsurance of 0% to 20%, and group sessions have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, requiring prior authorization and a doctor referral. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered with a 20% coinsurance for both ground and air ambulance services, while transportation services to plan-approved health-related locations are covered with no copay for up to 24 one-way trips per year via taxi or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered, with a $110 copay for emergency services, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services are covered, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, all with no copay and no coinsurance.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with a 0% to 20% coinsurance, Chiropractic Services with a 20% coinsurance (routine care not covered), Occupational Therapy Services with a 0% to 20% coinsurance, Physician Specialist Services with a 0% to 20% coinsurance, Mental Health Specialty Services, Individual Sessions with a 0% to 20% coinsurance, and Group Sessions with a 20% coinsurance, Podiatry Services with a 20% coinsurance (routine foot care) and no copay, Other Health Care Professional with a 0% to 20% coinsurance, Psychiatric Services, Individual Sessions with a 0% to 20% coinsurance, and Group Sessions with a 20% coinsurance, Physical Therapy and Speech-Language Pathology Services with a 0% to 20% coinsurance, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
The UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan covers preventive services, including an annual physical exam with no copay, and other preventive services with varying copays and coinsurance. Fitness benefits and home and bathroom safety devices and modifications are covered with no copay. Other services like health education, and counseling services are not covered.
Hearing Services See details
The UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan covers hearing exams with at most 20% coinsurance, routine hearing exams with no copay, and prescription hearing aids with no copay, up to $1500 every year. This plan also covers OTC hearing aids with no copay. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan covers vision services, including routine eye exams and eyewear. Routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames have no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventative dental services with no copay; however, it does not cover implant services or orthodontics. Medicare Dental Services are covered with 20% coinsurance.
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 the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization and a doctor referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NV-S001 (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 not covered by the UHC Dual Complete NV-S001 (HMO-POS D-SNP) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. The plan does not cover additional days beyond Medicare-covered for SNF, nor does it cover non-Medicare-covered stays for SNF.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefit, with no copay for either. 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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