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 2026, 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 Select Counties in Kentucky. This plan received an overall rating of 4 out of 5 stars in 2026.
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 $38.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.90. 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 $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 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) Medicare plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs filled at a standard pharmacy or through standard mail order. This zero-cost benefit applies to both 1-month and 3-month supplies of preferred generic medications. For all other formulary tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy fills as well as standard mail-order options for covered durations. These clear cost-sharing tiers make it easy to estimate your out-of-pocket drug expenses with this plan.
Additional Benefits
The UHC Dual Complete KY-S3 (PPO D-SNP) plan offers comprehensive medical coverage, featuring no copays for primary care and specialist visits alongside coinsurance between 0% and 20%. Inpatient hospital stays require a $2,000 copay per admission with no coinsurance, while emergency room visits carry a $115 copay that is waived upon admission. Most outpatient services, home health visits, and skilled nursing facility stays also feature no copays, though some services require coinsurance and prior authorization. Supplemental benefits include dental, vision, and hearing coverage, with no copays for routine eye exams and preventive dental care up to a $2,000 annual limit. Prescription and over-the-counter hearing aids are covered with no copay and no coinsurance up to two aids every two years, alongside no-copay benefits for over-the-counter items and chronic illness meals. Additionally, members pay no copay and a 20% coinsurance for durable medical equipment, dialysis, and ambulance services.
Inpatient Hospital See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $2,000 copay per admission and no coinsurance. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers outpatient services with no copays, though coinsurance and prior authorization are required for most services. Outpatient hospital, ambulatory surgical center, and substance abuse services feature no copay with coinsurance ranging from no coinsurance to 20%, while observation and outpatient blood services require a 20% coinsurance.
Partial Hospitalization See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers ambulance services with a 20% coinsurance and no copay for both ground and air transport. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete KY-S3 (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 feature no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while physical, occupational, and speech therapies require no copay and 20% coinsurance. Telehealth and opioid treatment services are available with no copay and no coinsurance, but chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance, though digital rectal exams and EKGs require a 20% coinsurance and no copay. Additional preventive benefits are partially covered with no copay or coinsurance for fitness, weight management, caregiver support, in-home support, and home safety, but exclude health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission 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
UHC Dual Complete KY-S3 (PPO D-SNP) partially covers hearing services, offering one annual routine hearing exam with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to two aids every two years (with a $2,500 maximum benefit for prescription aids), 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 KY-S3 (PPO D-SNP) with no copays, no coinsurance, and no deductibles for routine eye exams and eyewear, which has a $200 annual limit. Covered benefits include one routine eye exam, contact lenses, eyeglass lenses, and eyeglass frames per year, while other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete KY-S3 (PPO D-SNP), featuring Medicare-covered dental with no copay and 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance up to a $2,000 annual limit. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete KY-S3 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, are covered with coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Dual Complete KY-S3 (PPO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with no copay and a 20% coinsurance for most items. 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 KY-S3 (PPO D-SNP) and require prior authorization. Outpatient diagnostic procedures and tests require a copay and a minimum 20% coinsurance, lab services have no copay but require coinsurance, and radiological services feature no copays with coinsurance ranging from none for diagnostic radiology to a minimum of 20% for therapeutic radiology and X-rays.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete KY-S3 (PPO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered as an additional benefit under the UHC Dual Complete KY-S3 (PPO D-SNP) plan, with Medicare-covered cardiac, pulmonary, and SET for PAD rehabilitation services requiring a 20% coinsurance and no copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by UHC Dual Complete KY-S3 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required. The plan allows admission without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete KY-S3 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. Prior authorization is required for the meal benefit.
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