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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:
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Drug Coverage
The UHC Dual Complete FL-D003 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for 1-month and 3-month supplies at standard pharmacies, as well as no copay for 3-month standard mail orders. This coverage ensures that members can obtain essential generic medications without any out-of-pocket copayments. For Tier 2 generic and Tier 3 preferred brand drugs, members pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and through standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance for a 1-month supply. This consistent coinsurance structure helps you easily estimate your out-of-pocket costs for higher-tier and specialty medications.
Additional Benefits
The UHC Dual Complete FL-D003 (PPO D-SNP) offers comprehensive medical coverage, featuring inpatient hospital stays with a $1,795 copay per stay and outpatient services with no copay and 0% to 20% coinsurance. Primary care and specialist visits require no copays with coinsurance up to 20%, while emergency room care has a $115 copay that is waived if admitted within 24 hours. Additionally, skilled nursing facility care and home health services are covered with no copay and no coinsurance. For extra wellness support, the plan includes routine dental services with no copay up to a $1,500 annual limit and routine vision coverage with a $250 yearly eyewear allowance. Members also benefit from a $2,200 hearing aid allowance every two years and up to 36 one-way plan-approved transportation trips per year with no copay. Over-the-counter benefits, fitness programs, and diagnostic lab services are also covered with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete FL-D003 (PPO D-SNP) with a $1,795 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions, subject to prior authorization. Unlimited additional acute days are included with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers outpatient services with no copay, though a coinsurance of 0% to 20% applies to outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services are also covered with no copay and a 20% coinsurance, and prior authorization is required for most of these benefits.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete FL-D003 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
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, offering up to 36 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete FL-D003 (PPO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under UHC Dual Complete FL-D003 (PPO D-SNP) are covered with no copays and coinsurance ranging from no coinsurance up to 20% for PCP, specialist, therapy, mental health, and podiatry services. Chiropractic care is partially covered, offering up to 12 routine visits per year with no copay and no coinsurance, while other chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers preventive services, offering annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance. Digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance, while supplemental fitness, weight management, home safety, in-home support, and caregiver training are covered with no copay. Additional preventive benefits are partially covered, as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete FL-D003 (PPO D-SNP) with no copay and no coinsurance for routine exams, OTC hearing aids, and prescription hearing aids up to a $2,200 limit every two years. Fitting and evaluation for hearing aids, as well as 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 copay, no coinsurance, and no deductible, including one routine eye exam yearly and a $250 annual eyewear allowance. While contact lenses and eyeglasses (lenses and frames) are covered, other eye exams, standalone eyeglass lenses, and standalone eyeglass frames are not covered.
Dental Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Medicare dental services with no copay and 20% coinsurance, alongside other diagnostic and preventive services with no copay or coinsurance up to a $1,500 yearly limit. While most comprehensive dental services are covered, implant and orthodontic services 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 and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance of 0% (no coinsurance) to 20%, while Part B insulin drugs require a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers durable medical equipment (DME), medical supplies, prosthetic devices, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, though prior authorization is required for these benefits and manufacturer limitations may apply to diabetic supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Dual Complete FL-D003 (PPO D-SNP) plan with prior authorization, featuring no copays for lab services and no copays or coinsurance for diagnostic radiology. Diagnostic procedures, therapeutic radiology, and outpatient X-rays require a 20% coinsurance, with diagnostic procedures also subject to a copayment.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete FL-D003 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Cardiac Rehabilitation Services with no copay and prior authorization, but in practice some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete FL-D003 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization is required for this benefit, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete FL-D003 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. Acupuncture and other additional services under this category are not covered, and prior authorization is required for the meal benefit.
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