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UHC Dual Complete IN-S002 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete IN-S002 (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 IN-S002 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete IN-S002 (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 Indiana. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete IN-S002 (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 IN-S002 (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 IN-S002 (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 IN-S002 (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 $0.90. 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 IN-S002 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you qualify, your Part D premium will be $49.60. After your total drug costs reach $2000, you will enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Dual Complete IN-S002 (PPO D-SNP) plan offers a wide range of benefits. This includes coverage for inpatient and outpatient services, with varying copays and coinsurance depending on the service. Emergency and preventive services, such as an annual physical exam, often have no copay. The plan also provides coverage for vision, dental, and hearing services. Vision includes routine eye exams and eyewear with no copay, while dental covers a range of services with no copay, and hearing includes hearing exams and prescription hearing aids with no copay. Additional benefits include coverage for ambulance services, home health, and medical equipment, with some services requiring coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $1750 per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered, with coinsurance ranging from 0% to 20%. Observation services are covered with 20% coinsurance, and Ambulatory Surgical Center (ASC) Services are covered with coinsurance between 0% and 20%. Individual sessions for outpatient substance abuse have coinsurance between 0% and 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 by the UHC Dual Complete IN-S002 (PPO D-SNP) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete IN-S002 (PPO D-SNP) plan, including ground and air ambulance services, both with a 20% coinsurance. Transportation Services to plan-approved health-related locations are covered with no copay for up to 36 one-way trips per year, while 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 and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with a coinsurance between 0% and 20%. Chiropractic services are covered with a 20% coinsurance, but routine care is not covered. Occupational Therapy Services are covered with a coinsurance between 0% and 20%. Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services are covered with a coinsurance between 0% and 20%. Mental Health Specialty Services are covered, with individual sessions having a coinsurance between 0% and 20%, and group sessions having a 20% coinsurance. Podiatry Services are covered, with a coinsurance of 20% for routine foot care, and no copay. Other Health Care Professional and Psychiatric Services are covered with a coinsurance between 0% and 20%. Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional services that may have a copay. Glaucoma screenings, Diabetes Self-Management Training, and Barium Enemas have no copay, while Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
The UHC Dual Complete IN-S002 (PPO D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, and prescription hearing aids with no copay and up to $2200 per year for both in-network and out-of-network services. The plan also covers OTC hearing aids with no copay, and 2 hearing aids 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 includes coverage for eye exams and eyewear. Routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, while eyeglasses (lenses and frames) and upgrades are not covered. The plan offers a combined maximum of $300 per year for eyewear.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance. 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 & fixed), Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery are also covered with no copay, but Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete IN-S002 (PPO D-SNP) plan, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with coinsurance for Medicare-covered items, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete IN-S002 (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 IN-S002 (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 covered by the UHC Dual Complete IN-S002 (PPO D-SNP) plan, but the plan does not cover any of the listed cardiac rehabilitation services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered. Prior authorization is required, and the cost sharing for SNF services is defined by Medicare.
Other Services See details
The "Other Services" benefit for UHC Dual Complete IN-S002 (PPO D-SNP) covers over-the-counter items and meal benefits with no copay, but 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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