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UHC Dual Complete FL-D003 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete FL-D003 (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 FL-D003 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete FL-D003 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Florida. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete FL-D003 (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 FL-D003 (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 FL-D003 (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 FL-D003 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.60. 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 combined Maximum Out-Of-Pocket cost of $14000.00 (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 $14000.00 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 FL-D003 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you will pay nothing for your covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D will be $20.30.
Additional Benefits
The UHC Dual Complete FL-D003 (PPO D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying cost-sharing. You'll pay a copay of $1685 per admission for inpatient hospital stays, and coinsurance for outpatient services between 0% and 20%. Emergency and urgent care services have copays, and preventive services such as annual physical exams have no copay. The plan also includes coverage for hearing, vision, and dental services. Hearing exams and hearing aids are covered, with a yearly allowance for hearing aids. Vision benefits include eye exams and eyewear, with a yearly maximum for eyewear. Dental services include coverage for many services with no copay, and other dental services with a $2,500 annual maximum.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For a Medicare-covered stay, there is a copay of $1685 per admission or stay, with no coinsurance. Additional days for Inpatient Hospital-Acute have no copay, and Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a coinsurance of 0% - 20%, while Observation Services have a 20% coinsurance. Ambulatory Surgical Center Services have a coinsurance between 0% and 20%. Individual Sessions for Outpatient Substance Abuse have a coinsurance between 0% and 20%, and Group Sessions have a 20% coinsurance. Outpatient Blood Services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services, and transportation services to plan-approved health-related locations. Ground and air ambulance services have a 20% coinsurance, while transportation services have 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 under the UHC Dual Complete FL-D003 (PPO D-SNP) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete FL-D003 (PPO D-SNP) plan covers primary care physician services with a coinsurance of 0% - 20%. Chiropractic services, including routine care, are covered with no copay. Occupational therapy services are covered with a coinsurance of 0% - 20%. Physician specialist services and mental health specialty services are covered with a coinsurance of 0% - 20%.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Other preventive services are covered, including fitness benefits, with no copay, and home and bathroom safety devices and modifications, also with no copay; however, services such as health education, in-home safety assessments, and counseling services are not covered. Glaucoma screenings, Diabetes Self-Management Training, and Barium Enemas have no copay, while Digital Rectal Exams and EKG following Welcome Visit have 20% coinsurance.
Hearing Services See details
Hearing exams are covered with no copay, including routine hearing exams (1 exam per year). Prescription hearing aids are covered, up to $2200 per year, with no copay for two hearing aids per year; however, fitting/evaluation for hearing aids, and prescription hearing aids for inner and outer ears are not covered. OTC hearing aids are covered with no copay for 2 hearing aids per year.
Vision Services See details
The UHC Dual Complete FL-D003 (PPO D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, while the plan offers a combined maximum of $400 per year for eyewear.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, and other dental services with a $2,500 maximum benefit each year. Some services such as 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. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete FL-D003 (PPO D-SNP) plan, but require prior authorization. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the UHC Dual Complete FL-D003 (PPO D-SNP) plan, with a 20% coinsurance for Durable Medical Equipment, Prosthetic Devices, and Medical Supplies. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. 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 FL-D003 (PPO 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 FL-D003 (PPO D-SNP) plan. The plan does not cover any of the sub-services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete FL-D003 (PPO D-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and the plan uses the Medicare-defined cost share for tier 1, with more copay information available.
Other Services See details
Other Services include coverage for over-the-counter items and meal benefits, with over-the-counter items having no copay, and meal benefits requiring prior authorization and no copay. 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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