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UHC Dual Complete LA-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete LA-S001 (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 LA-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete LA-S001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Louisiana. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete LA-S001 (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 LA-S001 (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 LA-S001 (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 LA-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.90. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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 $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 LA-S001 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete LA-S001 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 preferred generic drugs purchased in 1-month or 3-month supplies at standard pharmacies. This zero-cost coverage also applies to 3-month standard mail-order fills of preferred generic medications. For Tier 2 generic and Tier 3 preferred brand drugs, members pay a 25% coinsurance for both 1-month and 3-month supplies through standard pharmacies and standard mail-order services. Similarly, Tier 4 non-preferred drugs and Tier 5 specialty tier medications require a 25% coinsurance for a 1-month supply.
Additional Benefits
The UHC Dual Complete LA-S001 (PPO D-SNP) offers comprehensive medical coverage with many services featuring no copay and no deductible. Primary care, specialist visits, outpatient hospital services, and home health care require no copay, though some services may have a coinsurance of up to 20%. Inpatient hospital stays require a copay of $2,175 per acute stay and $2,080 per psychiatric stay, but feature no coinsurance. This plan also includes key everyday benefits like routine dental, vision, and hearing care with no copay and no coinsurance. Dental care is covered up to a $2,000 annual limit, while prescription and over-the-counter hearing aids are covered up to $2,200 every two years. Additionally, the plan supports your wellness with no-copay benefits for over-the-counter items, meal services, and up to 24 one-way transportation trips per year.
Inpatient Hospital See details
UHC Dual Complete LA-S001 (PPO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,175 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Unlimited additional acute care 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 LA-S001 (PPO D-SNP) covers outpatient services with no copays, with coinsurance ranging from no coinsurance up to 20% depending on the service. Prior authorization is required for outpatient hospital, ambulatory surgical center, substance abuse, and blood services, which also feature no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete LA-S001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
UHC Dual Complete LA-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete LA-S001 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $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
UHC Dual Complete LA-S001 (PPO D-SNP) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while telehealth and opioid treatment are available with no copay and no coinsurance. Physical, occupational, speech, and mental health therapies require no copay and up to 20% coinsurance, while chiropractic services are partially covered, with routine and other chiropractic care not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete LA-S001 (PPO D-SNP), offering annual physicals, kidney disease education, fitness programs, weight management, in-home support, caregiver support, glaucoma screenings, and diabetes self-management with no copay and no coinsurance, while digital rectal exams and EKGs require a 20% coinsurance and no copay. Several services are not covered, including health education, personal emergency response systems (PERS), in-home safety assessments, 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 access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete LA-S001 (PPO D-SNP), including one routine hearing exam annually with a 20% coinsurance and no copay, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to a $2,200 maximum limit every two years, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay, no coinsurance, and no deductible, featuring one routine eye exam per year and a $150 annual limit for contacts, lenses, and frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete LA-S001 (PPO D-SNP), as implant services and orthodontics are not covered. Medicare-covered dental services have no copay and a 20% coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Medical equipment is covered under the UHC Dual Complete LA-S001 (PPO D-SNP) plan with no copays and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with prior authorization required. Diagnostic radiological services have no copay and no coinsurance, whereas lab services have no copay but require coinsurance, and diagnostic procedures require a copay and 20% coinsurance. Therapeutic radiological and outpatient X-ray services are covered with no copay and 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay and prior authorization required, though only some services are covered. Sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete LA-S001 (PPO D-SNP) with no copay and no coinsurance, and the plan does not require 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 LA-S001 (PPO D-SNP), which offers over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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