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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 $1.10. 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, you will pay the costs for your drugs based on the specific tier and pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. Those who qualify for the low-income subsidy will pay $20.30 per month for their Part D premium.
Additional Benefits
The UHC Dual Complete FL-D003 (PPO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays will cost a $1580 copay per admission, while outpatient services and primary care have coinsurance requirements. This plan also offers many services with no copay, including hearing exams, vision exams, dental services, home health, and many preventative services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, you will pay a copay of $1580 per admission or stay, and for Additional Days (91-999), there is no copay. 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%, Observation Services have a 20% coinsurance, Individual Sessions for Outpatient Substance Abuse have a coinsurance of 0% - 20%, Group Sessions for Outpatient Substance Abuse have a 20% coinsurance, and Outpatient Blood Services have a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the UHC Dual Complete FL-D003 (PPO D-SNP) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance, as well as transportation services with 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. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency, Urgent, and Transportation services have no copay. All services have no coinsurance.
Primary Care See details
The UHC Dual Complete FL-D003 (PPO D-SNP) plan covers primary care physician services with a coinsurance between 0% and 20%, chiropractic services with no copay, occupational therapy services with a coinsurance between 0% and 20%, and specialist services with a coinsurance between 0% and 20%. The plan also offers mental health, podiatry, other health professional, psychiatric, and physical therapy services with varying coinsurance, and additional telehealth benefits with no copay. Additionally, opioid treatment program services are covered with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services and an annual physical exam with no copay, while other preventive services may have a copay or coinsurance. Some additional services like 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 EKGs following a Welcome Visit have 20% coinsurance.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a maximum benefit of $2,200 every year, and OTC hearing aids are covered with no copay, up to 2 hearing aids every year.
Vision Services See details
The UHC Dual Complete FL-D003 (PPO D-SNP) plan covers vision services, including eye exams with no copay, and eyewear with no copay, up to a combined maximum of $400 per year. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental Services are covered, with Medicare Dental Services requiring prior authorization and a 20% coinsurance. Other Dental Services include 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, Maxillofacial Prosthetics, and Prosthodontics, fixed, all with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 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. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation 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 require prior authorization. This plan follows the original Medicare cost share for tier 1, and 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
The UHC Dual Complete FL-D003 (PPO D-SNP) plan covers Over-the-Counter (OTC) items and Meal Benefits with 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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