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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 2025, 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 out of 5 stars in 2025.
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 $6.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. 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 Complete Care Support EP-1A (PPO C-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs, but the specific amounts for each tier are not listed. This plan offers a Part D premium reduction for those who qualify for the low-income subsidy. With this subsidy, you will pay $6.50 for your Part D drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Complete Care Support EP-1A (PPO C-SNP) plan offers a range of benefits. This plan covers inpatient hospital stays with a $1080 copay per admission, and outpatient services with varying coinsurance. Emergency, primary care, preventive, hearing, vision, and dental services are available with no copay. Additional benefits include ambulance services with 20% coinsurance, and no copay for transportation to a plan-approved health-related location. The plan also covers home health services, medical equipment, and diagnostic services with varying coinsurance, and offers no copay for over-the-counter items and meal benefits. Some services, like cardiac rehabilitation and certain types of care, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered by the UHC Complete Care Support EP-1A (PPO C-SNP) plan. For Inpatient Hospital-Acute, the copay is $1080 per admission or stay, and additional days for days 91-999 have no copay.
Outpatient Services See details
Outpatient Services, including all Outpatient Hospital Services, are covered, with coinsurance of 0% - 20% for Outpatient Hospital Services and 20% for Observation Services. Ambulatory Surgical Center (ASC) Services are covered with coinsurance between 0% and 20%, while Individual and Group Sessions for Outpatient Substance Abuse have no copay. Outpatient Blood Services are covered with 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care Support EP-1A (PPO C-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 Complete Care Support EP-1A (PPO C-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to a plan-approved health-related location has no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Complete Care Support EP-1A (PPO C-SNP) plan covers primary care physician services with no copay. Chiropractic services require prior authorization and have a $15 copay. Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay. Individual and Group Sessions for Mental Health Specialty Services and Psychiatric Services have no copay. Podiatry Services, Other Health Care Professional, and Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services, which may have a copay. Other preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and others are not covered. Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay and include 1 routine exam per year; prescription hearing aids have a maximum benefit of $1500 per year, and OTC hearing aids have no copay, with a limit of 2 hearing aids per year. Fitting/evaluation for hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The UHC Complete Care Support EP-1A (PPO C-SNP) plan covers vision services, including routine eye exams with no copay, and eyewear with a combined maximum benefit of $300 per year. Contact lenses, eyeglass lenses, and eyeglass frames have no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, and other preventive services, are covered with no copay. This plan also covers restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery with no copay, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the UHC Complete Care Support EP-1A (PPO C-SNP) plan and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care Support EP-1A (PPO C-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies also have a 20% coinsurance, and there is no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Complete Care Support EP-1A (PPO C-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay, and 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 Complete Care Support EP-1A (PPO C-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 not covered by the UHC Complete Care Support EP-1A (PPO C-SNP) plan. Though the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, none of these are covered.
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 copay information is available in the plan details.
Other Services See details
The UHC Complete Care Support EP-1A (PPO C-SNP) plan does not cover 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. Over-the-counter items and meal benefits are covered with no copay, and meal benefits require prior authorization.
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