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UHC Complete Care Support EP-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 EP-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 EP-1A (PPO C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care Support EP-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 EP-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 EP-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 EP-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 EP-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. 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:
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Drug Coverage
The UHC Complete Care Support EP-1A (PPO C-SNP) Medicare plan features an annual prescription drug deductible of $615. This drug deductible is the amount you will need to pay out-of-pocket for your medications before your plan coverage kicks in. Understanding this initial cost is a key factor when comparing Medicare Advantage plans and estimating your yearly healthcare expenses. Specific drug coverage tier details, such as copays and coinsurance for generic or brand-name drugs, are not available for this plan. To find out how much your specific prescriptions will cost, you should consult the plan's formulary or contact the provider. This will help you determine your total out-of-pocket costs and ensure your necessary medications are covered.
Additional Benefits
The UHC Complete Care Support EP-1A (PPO C-SNP) plan offers comprehensive medical coverage with many essential services featuring no copays and no coinsurance, including primary care, specialist visits, preventive care, and lab services. For inpatient hospital stays, members pay a $1,940 copay per admission, while emergency room visits require a $115 copay that is waived if admitted. Other services, such as outpatient hospital care, durable medical equipment, and dialysis, generally require a 20% coinsurance. This plan also includes valuable everyday benefits to support your health and budget. Members enjoy no copays or coinsurance for routine hearing exams, routine eye exams with a $300 annual allowance for eyewear, and preventive dental care up to a $1,500 yearly limit. Additionally, the plan provides up to 24 one-way trips to approved locations and over-the-counter items at no cost.
Inpatient Hospital See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers inpatient acute and psychiatric hospital stays with a $1,940 copay per admission and no coinsurance, requiring prior authorization. This benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers outpatient services with no copays, though coinsurance of up to 20% may apply for outpatient hospital, observation, and ambulatory surgical center services. Outpatient substance abuse services feature no copay and no coinsurance, while outpatient blood services require no copay and a 20% coinsurance with the deductible waived for the first three pints.
Partial Hospitalization See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
UHC Complete Care Support EP-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, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Complete Care Support EP-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 require a copay of $0 to $40 and 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 EP-1A (PPO C-SNP) provides primary care, specialist, telehealth, mental health, and podiatry services with no copay and no coinsurance. Physical therapy requires a $55 copay and occupational therapy requires a $35 copay, both with no coinsurance, while chiropractic services are not covered because routine and other chiropractic care are excluded.
Preventive Services See details
Preventive services are covered with no copay and no coinsurance under UHC Complete Care Support EP-1A (PPO C-SNP), including annual physical exams, kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and EKGs. Additional preventive benefits are partially covered, offering fitness benefits and home safety modifications with no copay and no coinsurance, but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) provides partial coverage for hearing services, featuring no copays or coinsurance for routine exams, prescription hearing aids, and over-the-counter hearing aids. However, fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) offers partially covered vision services with no copay and no coinsurance, including one routine eye exam yearly and a $300 annual combined limit for contacts, eyeglass lenses, and frames. Other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered, and eye exams require prior authorization.
Dental Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) offers partially covered dental services, with implant services and orthodontics not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $1,500 annual maximum.
Home Infusion bundled Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers home infusion bundled services with no copay, subject to prior authorization and step therapy. Associated Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin has a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care Support EP-1A (PPO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and 20% coinsurance. Diabetic supplies are also covered with no copay, and prior authorization is required for these medical equipment services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care Support EP-1A (PPO C-SNP) with prior authorization. Diagnostic radiological services have no copay and no coinsurance, and lab services feature no copay. Outpatient diagnostic tests require a copay and 20% coinsurance, while therapeutic radiology and outpatient X-rays carry a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered by UHC Complete Care Support EP-1A (PPO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the UHC Complete Care Support EP-1A (PPO C-SNP) require prior authorization and feature no copay and no coinsurance. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care Support EP-1A (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, though Medicare-defined cost-sharing and prior authorization are required. The plan allows for admission with less than a three-day prior hospital stay, but additional days beyond Medicare-covered limits are not covered.
Other Services See details
UHC Complete Care Support EP-1A (PPO C-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though meals require prior authorization. Acupuncture is not covered under this benefit.
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