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UHC Dual Complete NV-S5 (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-S5 (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-S5 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NV-S5 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Clark, Nye, and Washoe Counties. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that UHC Dual Complete NV-S5 (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-S5 (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-S5 (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-S5 (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. Additionally, this plan comes with a Part B Premium reduction of $0.30. 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 $514.00 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 NV-S5 (HMO-POS D-SNP) Medicare plan has an annual prescription drug deductible of $514. Members benefit from no copay for Tier 1 preferred generic and Tier 2 generic drugs, which applies to 1-month and 3-month supplies at standard pharmacies and 3-month standard mail orders. For higher-tier medications, costs are covered via coinsurance rather than flat copays. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail order fills. This 25% coinsurance applies to 1-month and 3-month supplies of Tier 3 drugs, and 1-month fills for Tier 4 and Tier 5 drugs.
Additional Benefits
The UHC Dual Complete NV-S5 (HMO-POS D-SNP) plan offers robust medical coverage with no copays for primary care and specialist visits, though some services may require up to 20% coinsurance. Inpatient hospital stays feature a $2,230 copay for acute care and a $2,080 copay for psychiatric care, but include unlimited additional acute days with no copay. Emergency services carry a $115 copay that is waived if you are admitted, while worldwide emergency care and home health services feature no copay and no coinsurance. For supplemental care, the plan provides valuable benefits with no copay, including a $250 annual vision allowance, up to $2,500 in yearly dental services, and up to 36 one-way transportation trips. Routine hearing exams carry a 20% coinsurance with no copay, but prescription hearing aids and over-the-counter items are covered with no copay and no coinsurance. Durable medical equipment, dialysis, and outpatient diagnostic tests generally require a 20% coinsurance and no copay.
Inpatient Hospital See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) partially covers inpatient hospital services with no coinsurance, featuring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Unlimited additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) covers outpatient services with no copays, while coinsurance ranges from no coinsurance up to 20% depending on the service. This coverage includes outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, with prior authorization and referrals required for care.
Partial Hospitalization See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Access to this benefit requires both prior authorization and a referral.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP) with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from $0 to $40 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 NV-S5 (HMO-POS D-SNP) covers primary care and specialist visits with no copays and 0% to 20% coinsurance, while telehealth and opioid treatment services feature no copays and no coinsurance. Physical, occupational, and speech therapy services require no copay and 20% coinsurance, though routine chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) provides partially covered preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and select supplemental benefits like fitness and personal emergency response systems. However, several services such as health education, nutritional benefits, and therapeutic massage are not covered, and certain procedures like digital rectal exams and post-welcome visit EKGs require a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP), which offers annual routine hearing exams with a 20% coinsurance and no copay, while fitting and evaluation services are not covered. Up to two prescription hearing aids (with a $2,200 limit every two years) and OTC hearing aids are covered with no copay and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) provides partial coverage for vision services with no copay and no coinsurance, including one routine eye exam and a $250 annual allowance for contacts, eyeglass lenses, and frames. Other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) offers partially covered dental services, featuring Medicare-covered dental with no copay and a 20% coinsurance, and other dental services with no copay and no coinsurance up to a $2,500 annual limit. Most preventive, diagnostic, and restorative treatments are covered, though implant and orthodontic services are not covered.
Home Infusion bundled Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs have no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete NV-S5 (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP), including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. These benefits feature no copay and a 20% coinsurance for DME, prosthetics, medical supplies, and diabetic therapeutic shoes, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Dual Complete NV-S5 (HMO-POS D-SNP) plan, though prior authorization and referrals are required. Diagnostic radiological services feature no copay and no coinsurance, lab services require no copay, and other diagnostic tests, therapeutic radiology, and outpatient X-rays carry a 20% minimum coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP) with no copay and no coinsurance. Members will need to obtain a referral and prior authorization before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the UHC Dual Complete NV-S5 (HMO-POS D-SNP) plan, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are excluded and subject to a 20% coinsurance. Although the overall benefit technically features no copay, prior authorization and referrals are required for any services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization and referrals are required. Admission is allowed with less than a three-day prior inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete NV-S5 (HMO-POS D-SNP), as acupuncture and other miscellaneous services are not covered. Covered benefits include over-the-counter (OTC) items and meal benefits for chronic illnesses, both of which feature no copay and no coinsurance, though prior authorization is required for meals.
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