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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 2026, 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 4 out of 5 stars in 2026.
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 $4.80. 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:
Sign up for UHC Dual Complete FL-D003 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete FL-D003 (PPO D-SNP) plan features an annual drug deductible of $615. For savings on everyday medications, Tier 1 preferred generic drugs are available with no copay for both 1-month and 3-month supplies at standard pharmacies and through standard mail order. This ensures affordable access to essential generic prescriptions. For all other drug tiers, the plan requires a 25% coinsurance for standard pharmacy and standard mail order fills. This 25% coinsurance rate applies to Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty medications. Knowing these cost-sharing details can help you better estimate your yearly prescription expenses under this plan.
Additional Benefits
The UHC Dual Complete FL-D003 (PPO D-SNP) offers comprehensive medical coverage featuring no copay for primary care visits, preventive screenings, and outpatient hospital services, though coinsurance of up to 20% may apply to some outpatient treatments. Inpatient hospital stays require a $1,905 copay per stay with no coinsurance, while emergency room visits carry a $115 copay that is waived upon admission. Additionally, members benefit from home health services and routine physical exams with no copay and no coinsurance. This plan also provides valuable supplemental benefits, including routine dental, vision, and hearing care with no copays and no coinsurance, subject to allowances like $1,500 for dental services and $250 for eyewear. Members can access up to 36 one-way transportation trips per year to plan-approved locations and over-the-counter items with no copay or coinsurance. Durable medical equipment and dialysis services are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete FL-D003 (PPO D-SNP) partially covers inpatient hospital services, which require a $1,905 copay per stay and no coinsurance for Medicare-covered acute and psychiatric stays. While unlimited additional acute days are covered with no copay, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers outpatient services with no copay, including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Coinsurance for these services ranges from no coinsurance to 20%, with outpatient blood services requiring 20% coinsurance and no deductible.
Partial Hospitalization See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance, providing up to 36 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers emergency services 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 of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits for UHC Dual Complete FL-D003 (PPO D-SNP) are covered with no copay and 0% to 20% coinsurance for primary care and specialist visits. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay and no coinsurance, while other chiropractic services are not covered. Most other covered therapy, mental health, and podiatry services require no copay and 0% to 20% coinsurance.
Preventive Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers preventive services, including annual physical exams and kidney disease education with no copay and no coinsurance. Additional preventive benefits are partially covered, excluding health education, safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote technologies, and counseling. Most covered screenings have no copay and no coinsurance, though a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete FL-D003 (PPO D-SNP), which offers no copay and no coinsurance for covered routine exams and hearing aids, including up to $2,200 every two years for prescription or OTC devices. Fitting and evaluation for hearing aids, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) offers partially covered vision services with no copays, no coinsurance, and no deductibles, including one routine eye exam per year and a $250 annual combined eyewear limit. Other eye exam services, eyeglass lenses, and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete FL-D003 (PPO D-SNP), offering a $1,500 annual maximum benefit for preventive and comprehensive care with no copay and no coinsurance. Medicare-covered dental services require no copay and a 20% coinsurance, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs require no coinsurance to 20% coinsurance, while insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under UHC Dual Complete FL-D003 (PPO D-SNP) with no copay and a 20% coinsurance, requiring prior authorization.
Medical Equipment See details
UHC Dual Complete FL-D003 (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 from specified manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers diagnostic and radiological services with prior authorization, offering diagnostic lab services with no copay and diagnostic tests with a copay and 20% minimum coinsurance. Radiological services feature no copays, with no coinsurance for diagnostic radiological services and a 20% minimum coinsurance for therapeutic radiology and outpatient X-rays.
Home Health Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Cardiac Rehabilitation Services with no copay and prior authorization required, though only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered under this benefit and require 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete FL-D003 (PPO D-SNP) with no coinsurance and Medicare-defined copayments, without requiring a prior three-day inpatient hospital stay. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete FL-D003 (PPO D-SNP), featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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