A non-government entity
UHC Dual Complete KY-S3 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete KY-S3 (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 KY-S3 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete KY-S3 (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 Kentucky. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete KY-S3 (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 KY-S3 (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 KY-S3 (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 KY-S3 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.10. 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:
Sign up for UHC Dual Complete KY-S3 (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 KY-S3 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The UHC Dual Complete KY-S3 (PPO D-SNP) plan offers a range of benefits with varying cost-sharing. You can expect a $1740 copay for inpatient hospital stays, with no copay for additional days. Outpatient services and primary care have coinsurance between 0% and 20%. Emergency services have a $110 copay, while urgent care has a copay between $0 and $45. The plan covers vision and dental services, including eye exams, eyewear, and dental procedures, with no copay for many services. Additionally, the plan covers home health services with no copay and provides coverage for hearing, medical equipment, and transportation 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, there is a copay of $1740 per admission or stay for Medicare-covered stays, and additional days have no copay.
Outpatient Services See details
Outpatient Services, including all Outpatient Hospital Services and Observation Services, are covered by this plan with coinsurance ranging from 0% to 20%, and a 20% coinsurance, respectively. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are also covered, with coinsurance between 0% and 20% for individual sessions, and 20% for group sessions. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Complete KY-S3 (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, with prior authorization required for all ambulance services. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location are covered with no copay, up to 48 one-way trips per year via taxi or medical transport. 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; there is no coinsurance for either. 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 KY-S3 (PPO D-SNP) plan covers Primary Care Physician Services with a coinsurance of 0% to 20%, Chiropractic Services with a 20% coinsurance, Occupational Therapy Services with a coinsurance of 0% to 20%, Physician Specialist Services with a coinsurance of 0% to 20%, Mental Health Specialty Services with a coinsurance of 0% to 20%, Podiatry Services with a coinsurance of 20% and no copay, Other Health Care Professional with a coinsurance of 0% to 20%, Psychiatric Services with a coinsurance of 0% to 20%, Physical Therapy and Speech-Language Pathology Services with a coinsurance of 0% to 20%, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
The UHC Dual Complete KY-S3 (PPO D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, but the plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, 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, and Counseling Services.
Hearing Services See details
Hearing services include routine hearing exams with no copay and at most 20% coinsurance, with one exam covered per year, and OTC hearing aids with no copay, with a limit of two hearing aids per year. Prescription hearing aids are covered up to a maximum of $2200 every year, and fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services with the UHC Dual Complete KY-S3 (PPO D-SNP) include eye exams and eyewear benefits. Eye exams and contact lenses have no copay, while eyeglass lenses and frames also have no copay, and you are limited to one pair of lenses and frames per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance and other dental services with a $2,000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic, prophylaxis, fluoride treatment, other preventive, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery services are covered with no copay, while implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete KY-S3 (PPO D-SNP) plan and require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits with the UHC Dual Complete KY-S3 (PPO D-SNP) plan include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance; Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services for the UHC Dual Complete KY-S3 (PPO D-SNP) plan include coverage for Diagnostic Procedures/Tests with a coinsurance of at most 20%, and Lab Services with no copay. Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are covered with a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete KY-S3 (PPO D-SNP) plan with no copay and no coinsurance, although Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete KY-S3 (PPO D-SNP) plan. Specifically, 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 are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and you will pay the Medicare-defined cost share for tier 1 services, but the specific copay is not detailed in the provided information.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, and Meal Benefits also have 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.
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