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UHC Complete Care Support NM-1A (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care Support NM-1A (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care Support NM-1A (PPO C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care Support NM-1A (PPO C-SNP) is a PPO C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New Mexico. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care Support NM-1A (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care Support NM-1A (PPO C-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 Complete Care Support NM-1A (PPO C-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 Complete Care Support NM-1A (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $491.00 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:
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Drug Coverage
The UHC Complete Care Support NM-1A (PPO C-SNP) prescription drug plan features an annual drug deductible of $491. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications purchased through standard pharmacies or standard mail order. For brand-name and specialty prescriptions, costs are determined by coinsurance rather than flat copays. Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail-order fills.
Additional Benefits
The UHC Complete Care Support NM-1A (PPO C-SNP) offers comprehensive medical coverage featuring no copay for primary care, specialist visits, and outpatient hospital services, though coinsurance up to 20% may apply. 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 preventive services, telehealth, and home health visits are available with no copay and no coinsurance. This plan also includes key supplemental benefits, including preventive and comprehensive dental care with no copay and no coinsurance up to a $1,500 annual limit. Vision services feature no copay and no coinsurance for annual routine exams and up to $100 for eyewear, while hearing aids are covered up to $1,500 every two years with no copay. Additionally, members can access up to 24 one-way transportation trips, over-the-counter items, and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers inpatient acute and psychiatric hospital stays with a $2,000 copay per admission and no coinsurance, subject to prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, while unlimited additional acute hospital days are covered with no copay.
Outpatient Services See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers outpatient services with no copay, though coinsurance ranges apply depending on the service. Outpatient hospital, ambulatory surgical center, and outpatient substance abuse services feature no copay and 0% to 20% coinsurance, while observation and outpatient blood services require no copay and 20% coinsurance.
Partial Hospitalization See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
UHC Complete Care Support NM-1A (PPO C-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 for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Complete Care Support NM-1A (PPO C-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 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers primary care and specialist services with no copay and 0% to 20% coinsurance, while physical, occupational, and speech therapies require no copay and 20% coinsurance. Telehealth, opioid treatment, and up to four routine podiatry visits per year are offered with no copay and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by UHC Complete Care Support NM-1A (PPO C-SNP), featuring no copay and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, and diabetes self-management training, while digital rectal exams and welcome-visit EKGs require a 20% coinsurance. Additional preventive benefits are partially covered, offering fitness programs and home safety devices at no copay and no coinsurance, but excluding health education, PERS, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services under UHC Complete Care Support NM-1A (PPO C-SNP) are partially covered, offering one annual routine hearing exam with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are covered with no copay and no coinsurance up to a $1,500 maximum benefit every two years, though inner ear, outer ear, and over-the-ear types are excluded. Up to two OTC hearing aids are also covered every two years with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Complete Care Support NM-1A (PPO C-SNP) with no copay and no coinsurance for covered benefits, which include one routine eye exam per year and up to $100 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
UHC Complete Care Support NM-1A (PPO C-SNP) offers partially covered dental services, with Medicare-covered dental care requiring no copay and a 20% coinsurance. Other preventive and comprehensive dental benefits feature no copay and no coinsurance up to a $1,500 annual maximum, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care Support NM-1A (PPO C-SNP) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by UHC Complete Care Support NM-1A (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers 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 and no copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care Support NM-1A (PPO C-SNP) and require prior authorization. Diagnostic procedures and tests require a copayment and 20% coinsurance, while lab services have no copay; radiological services feature no copays, with 20% coinsurance for therapeutic and X-ray services and no coinsurance for diagnostic radiology.
Home Health Services See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Complete Care Support NM-1A (PPO C-SNP) requires prior authorization for Cardiac Rehabilitation Services, where some services are covered with no copay and no coinsurance. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care Support NM-1A (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and Medicare-defined copays, requiring prior authorization but no prior three-day hospital stay. This benefit is partially covered, as additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Complete Care Support NM-1A (PPO C-SNP) partially covers other services, including over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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