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UHC Dual Complete NE-S002 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NE-S002 (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 NE-S002 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete NE-S002 (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 Nebraska. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete NE-S002 (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 NE-S002 (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 NE-S002 (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 NE-S002 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 Dual Complete NE-S002 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your Part D premium may be reduced to $50.60. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete NE-S002 (PPO D-SNP) plan offers a range of benefits. This plan includes coverage for inpatient hospital stays with a $1550 copay per admission, outpatient services with varying coinsurance, and emergency services with a $110 copay. The plan also covers primary care, preventive services, hearing, vision, and dental services. Many of these services have no copay, while others involve coinsurance. Additionally, this plan provides coverage for ambulance and transportation services, home health services, and skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital-Acute has a copay of $1550 per admission or stay for Medicare-covered stays, and additional days for Inpatient Hospital-Acute have no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric has a copay of $1550 per admission or stay for Medicare-covered stays, and additional days and non-Medicare covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 0% - 20% coinsurance, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 0% - 20% coinsurance, Individual Sessions for Outpatient Substance Abuse with a 0% - 20% coinsurance, Group Sessions for Outpatient Substance Abuse with a 20% coinsurance, and Outpatient Blood Services with a 20% coinsurance. Outpatient Blood Services include an enhanced benefit where the three-pint deductible is waived.
Partial Hospitalization See details
Partial Hospitalization is covered, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, each with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, and up to 36 one-way trips per year are covered. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by the UHC Dual Complete NE-S002 (PPO D-SNP) plan with a $110 copay and no coinsurance. Urgently needed services have a copay between $0 and $45, and no coinsurance, while worldwide emergency services have no coinsurance, and a copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
The UHC Dual Complete NE-S002 (PPO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services and physician specialist services have a coinsurance between 0% and 20%, while chiropractic services and routine foot care have a 20% coinsurance. Occupational therapy and mental health individual sessions have a coinsurance between 0% and 20%, and physical therapy and speech-language pathology services and other health care professional services have a coinsurance between 0% and 20%. Group sessions for mental health and psychiatric services have a 20% coinsurance. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional services with varying copays and coinsurance. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered. Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas have no copay, while Digital Rectal Exams and EKG following Welcome Visit have 20% coinsurance.
Hearing Services See details
The UHC Dual Complete NE-S002 (PPO D-SNP) plan covers hearing exams with a coinsurance of at most 20% and routine hearing exams with no copay. This plan also covers prescription hearing aids with no copay, and OTC hearing aids with no copay. Fitting/evaluation for hearing aids, and Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The UHC Dual Complete NE-S002 (PPO D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and contact lenses and eyeglass lenses are covered with no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance. Oral exams, dental X-rays, other diagnostic and preventive dental services, prophylaxis (cleaning), and fluoride treatment have no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. However, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
The UHC Dual Complete NE-S002 (PPO D-SNP) plan covers Home Infusion bundled Services, including Medicare Part B Insulin Drugs with a $35 copay and a coinsurance between 0% and 20%. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete NE-S002 (PPO D-SNP) plan, but require prior authorization. The coinsurance for Dialysis Services is between 20% and 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NE-S002 (PPO D-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 Dual Complete NE-S002 (PPO D-SNP) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete NE-S002 (PPO D-SNP) plan, with prior authorization required. The plan does not provide Skilled Nursing Facility Services as a supplemental benefit under Part C, but does allow less than a 3-day inpatient hospital stay prior to SNF admission, with no copay.
Other Services See details
The UHC Dual Complete NE-S002 (PPO D-SNP) plan's other services include no copay for over-the-counter items and meal benefits, which require prior authorization. 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 are not covered.
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