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UHC Dual Complete MS-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete MS-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 MS-S001 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete MS-S001 (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 Mississippi. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete MS-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 MS-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 MS-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 MS-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $2.90. 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 MS-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 based on the tier and pharmacy type until your total drug costs reach $2000. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D will be $41.20.
Additional Benefits
The UHC Dual Complete MS-S001 (PPO D-SNP) plan offers a range of benefits with varying cost-sharing. This plan includes coverage for inpatient hospital stays with a copay, and outpatient services and primary care with coinsurance. Emergency and urgent care services have a copay, and the plan also covers ambulance and transportation services with coinsurance. Additional benefits include no copay for preventive services, routine eye exams, and dental services. Hearing services, vision services, and dental services are covered, with no copays for many of these services, but with some coinsurance. The plan also offers coverage for home health services and medical equipment with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the UHC Dual Complete MS-S001 (PPO D-SNP) plan, with a $1,350 copay per admission or stay for Medicare-covered stays. 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, including all outpatient hospital services, are covered by the UHC Dual Complete MS-S001 (PPO D-SNP) plan, with coinsurance ranging from 0% to 20%. Observation Services have a 20% coinsurance, while Ambulatory Surgical Center (ASC) Services have a coinsurance ranging from 0% to 20%. Individual Sessions for Outpatient Substance Abuse have a coinsurance ranging from 0% to 20%, and Group Sessions have a 20% coinsurance. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Complete MS-S001 (PPO D-SNP) plan, requiring prior authorization, with a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, each with a 20% coinsurance. Transportation services to plan-approved health-related locations are covered, with 60 one-way trips per year and no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete MS-S001 (PPO D-SNP) plan. Emergency Services have a $110 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete MS-S001 (PPO D-SNP) plan covers primary care, with a coinsurance of 0% - 20% for Primary Care Physician Services. Chiropractic Services require prior authorization and have a 20% coinsurance, but routine chiropractic care is not covered. Occupational Therapy Services have a 0% - 20% coinsurance. Physician Specialist Services, Mental Health Specialty Services, and Psychiatric Services are covered with a 0% - 20% coinsurance, while Podiatry Services have a 20% coinsurance with no copay for Medicare-covered services. Other Health Care Professional services have a 0% - 20% coinsurance. Physical Therapy and Speech-Language Pathology Services have a 0% - 20% coinsurance. Additional Telehealth benefits are covered with no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services, including an annual physical exam, are covered. The annual physical exam has no copay. Other preventive services are covered, including Fitness Benefit, with no copay. Glaucoma screening, Diabetes Self-Management Training, and Barium Enemas have no copay. Digital Rectal Exams and EKG following a Welcome Visit have a 20% coinsurance. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
The UHC Dual Complete MS-S001 (PPO D-SNP) plan covers hearing exams with a coinsurance of at most 20% and no copay for routine hearing exams, which are limited to one per year. This plan also covers prescription hearing aids, with a maximum benefit of $2,500 every year and no copay for prescription hearing aids (all types), limited to two per year, as well as OTC hearing aids with no copay, limited to two per year. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Routine eye exams have no copay and are covered once per year, and contact lenses, eyeglass lenses, and eyeglass frames have no copay. Eyeglass lenses are covered once per year, and eyeglass frames are covered once per year. Eyewear has a combined maximum benefit of $400 per year for both in-network and out-of-network services, and eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services and an annual maximum of $2,500 for other dental services. 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 and fixed), oral and maxillofacial surgery, and maxillofacial prosthetics are covered with no copay. Orthodontic and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay, and between 0% and 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete MS-S001 (PPO D-SNP) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, with Durable Medical Equipment subject to 20% coinsurance. Prosthetic Devices and Medical Supplies are covered with a 20% coinsurance, while Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the UHC Dual Complete MS-S001 (PPO D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete MS-S001 (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 under the UHC Dual Complete MS-S001 (PPO D-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits 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 cost sharing information is available in the plan details.
Other Services See details
The UHC Dual Complete MS-S001 (PPO D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. Over-the-Counter (OTC) Items have no copay, while Meal Benefits also have no copay and 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.
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