A non-government entity
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 2025, 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 3.5 out of 5 stars in 2025.
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 $55.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.50. 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:
Sign up for UHC Dual Complete LA-S001 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete LA-S001 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your Part D premium may be reduced to $55.60. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete LA-S001 (PPO D-SNP) plan offers a wide range of benefits with varying cost-sharing options. Inpatient hospital stays have a $1270 copay per admission, while outpatient services, including blood services, have coinsurance between 0% and 20%. Emergency services have a $110 copay, and ambulance services have 20% coinsurance. This plan provides coverage for primary care, preventive services, hearing, vision, and dental services, often with no copay or coinsurance. Additionally, the plan covers home health services, home infusion, medical equipment, and diagnostic services with varying cost-sharing. The plan also includes benefits for transportation, and over-the-counter items, making it a comprehensive option for those seeking a plan with broad coverage.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, with a copay of $1270 per admission or stay for Medicare-covered stays, and no cost sharing on the day of discharge. Additional days for inpatient hospital acute have no copay, while 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 Outpatient Hospital Services with 0% to 20% coinsurance, Observation Services with 20% coinsurance, Ambulatory Surgical Center (ASC) Services with 0% to 20% coinsurance, Outpatient Substance Abuse Services with 0% to 20% coinsurance, and Outpatient Blood Services with 20% coinsurance. Outpatient Blood Services also includes a three-pint deductible waiver.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered with no copay, up to 60 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by the UHC Dual Complete LA-S001 (PPO D-SNP) plan, with a $110 copay and no coinsurance. Urgently needed services have a copay between $0 and $45 with no coinsurance, and Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services are covered with a coinsurance of 0% to 20%, while Chiropractic Services are covered with a 20% coinsurance. Occupational Therapy Services, Individual Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Other Health Care Professional services are covered with a coinsurance that ranges from 0% to 20%. Podiatry Services are covered with a coinsurance of 20% and no copay, while Group Sessions for Mental Health Specialty Services and Group Sessions for Psychiatric Services are covered with a 20% coinsurance. Additional Telehealth Benefits are covered with no copay, and Opioid Treatment Program Services are covered with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay. Other covered preventive services include glaucoma screening, diabetes self-management training, barium enemas, and digital rectal exams with no copay, as well as EKG following Welcome Visit, each with 20% coinsurance.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay and 20% coinsurance, and are limited to 1 visit per year. Prescription hearing aids are covered with a maximum benefit of $2,200 every year and OTC hearing aids have no copay.
Vision Services See details
The UHC Dual Complete LA-S001 (PPO D-SNP) plan covers vision services, including routine eye exams and eyewear. You will pay no copay for routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete LA-S001 (PPO D-SNP) plan covers Medicare Dental Services with 20% coinsurance after prior authorization, and other dental services with a $2,500 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, and the periodicity varies. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay after prior authorization, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. The plan covers Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete LA-S001 (PPO D-SNP) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
The UHC Dual Complete LA-S001 (PPO D-SNP) plan covers Durable Medical Equipment with a 20% coinsurance and requires prior authorization. Prosthetic Devices and Medical Supplies are covered, with a 20% coinsurance for Medicare-covered services, and a $0 copay for Diabetic Supplies. Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete LA-S001 (PPO D-SNP) plan. For Diagnostic Procedures/Tests and Diagnostic Radiological Services, you may pay up to 20% coinsurance, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of up to 20%.
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. 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 LA-S001 (PPO D-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for the services, but there is no information about the cost sharing for any of the services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays. Prior authorization is required, and the copay is determined by Medicare.
Other Services See details
The UHC Dual Complete LA-S001 (PPO D-SNP) plan's other services include Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay, both of which require prior authorization. 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved