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UHC Dual Complete SC-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete SC-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 SC-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete SC-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 South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete SC-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 SC-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 SC-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 SC-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $24.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $9250.00 (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 $9250.00 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 SC-S001 (PPO D-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs offer no copay for a 1-month or 3-month supply at standard pharmacies and standard mail order. For Tier 2 generic drugs, you will pay a 25% coinsurance for both 1-month and 3-month supplies at standard pharmacies and through standard mail order. Tier 3 preferred brand drugs also require a 25% coinsurance for 1-month and 3-month supplies through standard pharmacies and mail order. Additionally, Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. This plan structure helps you easily project your out-of-pocket prescription costs at standard retail pharmacies and mail-order services.
Additional Benefits
The UHC Dual Complete SC-S001 (PPO D-SNP) offers comprehensive medical coverage, featuring an $1,830 copay per stay with no coinsurance for inpatient hospital care. Outpatient services, primary care, and home health care are available with no copay, though some outpatient and primary care services may carry up to a 20% coinsurance. Emergency services require a $115 copay, which is waived upon admission, while urgent care features no copay or low copays. For supplemental health needs, the plan provides routine vision and dental care with no copay and no coinsurance, including a $3,000 annual limit for dental services and a $200 allowance for eyewear. Hearing aids and routine hearing exams are also covered with no copay, though exams require a 20% coinsurance. Additionally, members can access over-the-counter items, chronic illness meal benefits, and skilled nursing facility care with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with an $1,830 copay per stay and no coinsurance, requiring prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, while unlimited additional acute days are covered with no copay.
Outpatient Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) offers outpatient services with no copay, with coinsurance ranging from no coinsurance up to 20% depending on the service. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse treatment, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete SC-S001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Additionally, the plan offers unlimited one-way transportation to plan-approved health-related locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits for UHC Dual Complete SC-S001 (PPO D-SNP) are covered with no copay and coinsurance ranging from no coinsurance to 20%. Chiropractic services are only partially covered, as routine chiropractic care is not covered, while telehealth and opioid treatment services are available with no copay and no coinsurance.
Preventive Services See details
Preventive services are covered by UHC Dual Complete SC-S001 (PPO D-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, diabetes self-management, and glaucoma screenings, though EKGs require a 20% coinsurance with no copay, and digital rectal exams require a 20% coinsurance. Additional supplemental benefits are partially covered with no copay and no coinsurance for fitness, caregiver support, in-home support, weight management, and home safety, whereas health education, in-home safety assessments, PERS, 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 are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete SC-S001 (PPO D-SNP), featuring routine hearing exams once per year with no copay and a 20% coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance for up to two devices every two years—with a $2,200 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 SC-S001 (PPO D-SNP) with no copay and no coinsurance, featuring one routine eye exam per year and a $200 annual limit for contact lenses, eyeglass lenses, and frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete SC-S001 (PPO D-SNP), with Medicare-covered dental services requiring no copay and a 20% coinsurance. Other covered preventive and comprehensive dental services feature no copay and no coinsurance up to a $3,000 annual maximum, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
UHC Dual Complete SC-S001 (PPO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic therapeutic shoes, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay under specified manufacturer limits, and prior authorization is required for most of these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete SC-S001 (PPO D-SNP) with prior authorization required. Diagnostic tests require a copay and a 20% minimum coinsurance, lab services have no copay, and radiological services have no copays, with coinsurance ranging from no coinsurance for diagnostic radiology to a 20% minimum coinsurance for therapeutic and X-ray services.
Home Health Services See details
Home health services are covered by UHC Dual Complete SC-S001 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) does not cover Cardiac Rehabilitation Services in practice, as key sub-services are not covered and require a 20% coinsurance. While the overall category lists no copay, specific services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by UHC Dual Complete SC-S001 (PPO D-SNP) with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete SC-S001 (PPO D-SNP) partially covers other services, providing over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance, though acupuncture is not covered. The meal benefit requires prior authorization, and both covered benefits feature no maximum plan coverage limits.
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