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UHC Dual Complete UT-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete UT-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 UT-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete UT-S001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Utah. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete UT-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 UT-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 UT-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 UT-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.60. 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 $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 Dual Complete UT-S001 (PPO D-SNP) Medicare plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for a 1-month or 3-month supply at a standard pharmacy, as well as no copay for a 3-month supply through standard mail order. For higher-tier medications, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies to both 1-month and 3-month supplies at standard pharmacies and standard mail order services where covered.
Additional Benefits
The UHC Dual Complete UT-S001 (PPO D-SNP) plan offers comprehensive coverage with no copays for many everyday healthcare needs, including primary care visits, outpatient services, and home health care. Preventive services, routine vision exams with a $200 eyewear allowance, and up to $2,000 in dental benefits are also covered with no copays. Additionally, members can receive routine hearing exams and up to two hearing aids every two years with no copay. For major medical services, inpatient hospital stays require a copay of $2,230 for acute care or $2,080 for psychiatric care per stay, while emergency room visits carry a $115 copay. Other essential services, such as ambulance transport, dialysis, and durable medical equipment, feature no copay but require a 20% coinsurance. This plan also provides convenient benefits like telehealth and over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Complete UT-S001 (PPO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. Unlimited additional acute care days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copays and coinsurance ranging from 0% to 20% depending on the service. Covered care includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with prior authorization required for most benefits.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete UT-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. For transportation services, some services are covered but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Dual Complete UT-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 feature a copay ranging from $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copays and no coinsurance.
Primary Care See details
Primary Care benefits for the UHC Dual Complete UT-S001 (PPO D-SNP) plan are covered with no copay and coinsurance ranging from 0% to 20% for services such as PCP visits, specialist consultations, therapies, and mental health care. Telehealth and opioid treatment services feature no copay and no coinsurance, while chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, diabetes self-management training, and glaucoma screenings, though a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs. Additional preventive benefits are partially covered with no copay or coinsurance for fitness, home safety devices, weight management, in-home support, and caregiver training, but 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/dietary benefits, home-based palliative care, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete UT-S001 (PPO D-SNP), offering annual routine hearing exams with no copay and a 20% coinsurance, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance (up to two aids and a $1,500 limit every two years), but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay, no coinsurance, and no deductible. The plan includes one routine eye exam and up to $200 annually for contact lenses, eyeglass lenses, or eyeglass frames, while upgrades, other eye exams, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete UT-S001 (PPO D-SNP), with implant services and orthodontics excluded from coverage. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a combined $2,000 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance. Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance, and prior authorization is required.
Dialysis Services See details
UHC Dual Complete UT-S001 (PPO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
UHC Dual Complete UT-S001 (PPO D-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, with prior authorization required for most medical equipment.
Diagnostic and Radiological Services See details
UHC Dual Complete UT-S001 (PPO D-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and diagnostic tests with a copay and minimum 20% coinsurance. Diagnostic radiological services have no copay and no coinsurance, while therapeutic radiology and outpatient X-rays require a minimum 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay and require prior authorization, though some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete UT-S001 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required. While the plan allows for admission without a prior three-day inpatient hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete UT-S001 (PPO D-SNP), offering no copay and no coinsurance for over-the-counter (OTC) items and meal benefits for chronic illnesses, though prior authorization is required for meals. Acupuncture and other miscellaneous services are not covered under this plan.
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