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UHC Dual Complete MI-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete MI-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 MI-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete MI-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 Michigan. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete MI-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 MI-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 MI-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 MI-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.80. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 MI-S001 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete MI-S001 (PPO D-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for 1-month and 3-month supplies at standard pharmacies, as well as for 3-month supplies through standard mail order. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a consistent 25% coinsurance. This 25% coinsurance applies to standard pharmacy fills and standard mail order options depending on the tier, providing a straightforward cost structure for your higher-tier medication needs.
Additional Benefits
The UHC Dual Complete MI-S001 (PPO D-SNP) plan offers comprehensive coverage with no copays for primary care visits, preventive services, outpatient care, and home health services, though some specialist visits and therapies may incur up to a 20% coinsurance. For major medical events, inpatient acute hospital stays require a $2,230 copay per stay, while emergency room visits carry a $115 copay that is waived upon hospital admission. Most diagnostic tests, dialysis, and durable medical equipment feature no copay and a 20% coinsurance. Additionally, the plan provides valuable supplemental benefits with no copays or coinsurance, including up to $2,000 annually for dental care, routine eye exams with a $200 eyewear allowance, and hearing aid coverage. Members also benefit from up to 24 one-way transportation trips per year to approved health locations, home infusion services, and over-the-counter benefits. Skilled nursing facility care is covered with Medicare-defined copays and no coinsurance, requiring prior authorization.
Inpatient Hospital See details
UHC Dual Complete MI-S001 (PPO D-SNP) partially covers inpatient hospital services, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute stays require a $2,230 copay per stay and no coinsurance, while covered psychiatric stays require a $2,080 copay per stay and no coinsurance.
Outpatient Services See details
Outpatient Services covered by UHC Dual Complete MI-S001 (PPO D-SNP) feature no copays, with coinsurance ranging from no coinsurance to 20% for outpatient hospital, ambulatory surgical, and substance abuse services. Outpatient blood services are also covered with no copay, no deductible, and a 20% coinsurance.
Partial Hospitalization See details
UHC Dual Complete MI-S001 (PPO D-SNP) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance, offering up to 24 one-way trips per year to plan-approved health-related locations, while trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete MI-S001 (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 require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care services under the UHC Dual Complete MI-S001 (PPO D-SNP) plan are covered with no copay and 0% to 20% coinsurance for primary care, specialist, and mental health visits. Physical, occupational, and speech therapies require no copay and 20% coinsurance, telehealth and opioid treatments have no copay and no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete MI-S001 (PPO D-SNP), offering no copay and no coinsurance for annual physical exams, kidney disease education, and select supplemental benefits like fitness and caregiver support, though some services like post-welcome visit EKGs require a 20% coinsurance. Sub-services that are not covered include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, smoking cessation counseling, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services covered by UHC Dual Complete MI-S001 (PPO D-SNP) include one annual routine hearing exam with no copay and 20% coinsurance, while fitting and evaluation services are not covered. The plan also covers up to two prescription hearing aids every two years up to a $2,200 limit and two OTC hearing aids every two years, both with no copay and no coinsurance. However, inner ear, outer ear, and over-the-ear prescription hearing aid types are not covered.
Vision Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) provides partially covered vision services with no copay and no coinsurance, which includes one routine eye exam and up to $200 annually for contact lenses, eyeglass lenses, and frames. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services under UHC Dual Complete MI-S001 (PPO D-SNP) are partially covered, with Medicare-covered dental services requiring no copay and a 20% coinsurance. Other covered preventive and comprehensive dental benefits feature no copay and no coinsurance up to a $2,000 annual limit for both in-network and out-of-network services, although implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, incur a coinsurance of up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete MI-S001 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete MI-S001 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, medical supplies, prosthetic devices, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete MI-S001 (PPO D-SNP) with prior authorization required. Diagnostic radiological services have no copay and no coinsurance, lab services feature no copay, and diagnostic tests, therapeutic radiology, and outpatient X-rays require a 20% coinsurance and applicable copays.
Home Health Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) does not cover Cardiac Rehabilitation Services in practice, as standard, intensive, pulmonary, and SET for PAD rehabilitation services are all not covered. If received, these services require a 20% coinsurance and no copay, and prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete MI-S001 (PPO D-SNP) with no coinsurance and Medicare-defined copays, requiring prior authorization. Admission does not require a prior three-day inpatient hospital stay, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete MI-S001 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture and other additional services under this category are not covered.
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