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UHC Dual Complete LA-S4 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete LA-S4 (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-S4 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete LA-S4 (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-S4 (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-S4 (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-S4 (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-S4 (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 $1.00. 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-S4 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete LA-S4 (PPO D-SNP) plan has an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for a 3-month standard mail-order supply. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to 1-month and 3-month supplies at standard pharmacies and standard mail order options, depending on the drug tier.
Additional Benefits
The UHC Dual Complete LA-S4 (PPO D-SNP) offers comprehensive medical coverage with many essential services requiring no copay, though some cost-sharing applies. For inpatient hospital stays, members pay a $1,640 copay per stay with no coinsurance, while outpatient care and doctor visits feature no copays and coinsurance ranging from 0% to 20%. Emergency room visits require a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Supplemental benefits are a highlight of this plan, featuring a $3,000 annual limit for dental care and routine vision exams with eyewear covered up to $200 annually, both with no copays. Hearing aids and routine hearing exams are also covered with no copays, while skilled nursing and home health services require no copay and no coinsurance. Additionally, most preventive care services and over-the-counter benefits are provided with no copays or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete LA-S4 (PPO D-SNP) with a $1,640 copay per stay and no coinsurance for both acute and psychiatric admissions. While unlimited additional acute care days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers outpatient services with no copays, with coinsurance ranging from no coinsurance to 20% depending on the service. These covered benefits include outpatient hospital care, ambulatory surgical center procedures, outpatient substance abuse sessions, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete LA-S4 (PPO D-SNP) with a $55.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, though this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits under UHC Dual Complete LA-S4 (PPO D-SNP) are covered with no copay and 0% to 20% coinsurance for primary care, specialist, and mental health services. Physical, occupational, and speech therapy services require no copay and a 20% coinsurance, while telehealth and opioid treatment programs are available with no copay and no coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete LA-S4 (PPO D-SNP), with most benefits—including annual physical exams, fitness programs, and kidney disease education—offered with no copay and no coinsurance. Some services like digital rectal exams and post-welcome visit EKGs require a 20% coinsurance, while several supplemental services, such as health education, personal emergency response systems, and nutritional benefits, are not covered.
Hearing Services See details
Hearing services under UHC Dual Complete LA-S4 (PPO D-SNP) include routine exams with no copay and 20% coinsurance, but fitting and evaluation services are not covered. Some prescription hearing aid services are covered up to $2,200 every two years with no copay or coinsurance, though inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are covered with no copay and no coinsurance for up to two devices every two years.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete LA-S4 (PPO D-SNP) with no copay and no coinsurance for routine exams and eyewear, which includes a $200 annual limit. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered under this plan.
Dental Services See details
Dental services are partially covered by UHC Dual Complete LA-S4 (PPO D-SNP), featuring a $3,000 annual maximum benefit for both in-network and out-of-network care. Medicare-covered dental services have no copay and a 20% coinsurance, while preventive and covered comprehensive services require no copay and no coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete LA-S4 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, incur a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete LA-S4 (PPO D-SNP) with prior authorization, featuring a copay and 20% coinsurance for diagnostic procedures, and no copay with applicable coinsurance for lab services. Radiological services require no copay, with no coinsurance for diagnostic radiology and 20% coinsurance for therapeutic radiology and outpatient X-rays.
Home Health Services See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required before you can receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Dual Complete LA-S4 (PPO D-SNP) with no copay and prior authorization required, but in practice, only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete LA-S4 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered because additional days beyond the Medicare-covered limit are not covered, though the plan does allow for admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered by UHC Dual Complete LA-S4 (PPO D-SNP), featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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* 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.
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