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UHC Complete Care MO-1 (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care MO-1 (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 MO-1 (PPO C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care MO-1 (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 Missouri. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Complete Care MO-1 (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 MO-1 (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 MO-1 (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 MO-1 (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 $340.00 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 $10100.00 (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 $10100.00 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 MO-1 (PPO C-SNP) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay an $8.00 copay for preferred generic drugs at a standard pharmacy. For non-preferred drugs, you will pay 29% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care MO-1 (PPO C-SNP) plan offers a wide range of benefits with varying costs. Many services have no copay, including primary care, preventive services, hearing exams, eye exams, and many dental services. The plan also covers hospital stays, outpatient services, and other specialty services with copays and coinsurance amounts that vary depending on the service. Additional benefits include transportation, emergency services, and home health services, often with no copay. The plan provides coverage for prescription hearing aids, eyeglasses, and durable medical equipment, but there may be copays or coinsurance involved.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $295 copay for days 1-8, and no copay for days 9-90, with no coinsurance; additional days have no copay. For Inpatient Hospital Psychiatric, you pay a $295 copay for days 1-7, and no copay for days 8-90, with no coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $295, observation services with a $295 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual sessions with a copay between $0 and $25, and group sessions with a $15 copay, while outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care MO-1 (PPO C-SNP) plan and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a $275 copay, and transportation services to plan-approved health-related locations with no copay for up to 24 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Complete Care MO-1 (PPO C-SNP) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $50; all other services have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay, but routine care is not covered. Occupational Therapy Services are covered with a copay between $0 and $20. Physician Specialist Services are covered with a copay between $0 and $30. Mental Health Specialty Services, including individual and group sessions, are covered with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Podiatry Services and Routine Foot Care are covered with no copay. Other Health Care Professional services are covered with a copay between $0 and $30. Psychiatric Services, including individual and group sessions, are covered with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $20. Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, and an annual physical exam with no copay. Additional preventive services, including Fitness Benefit, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications, are covered with no copay. Other services, such as Health Education, Counseling Services, and others, are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year with no copay. Prescription hearing aids are covered, with copays ranging from $199 to $1249, depending on the type of aid, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, 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 Complete Care MO-1 (PPO C-SNP) plan covers vision services, including eye exams with no copay, and eyewear with a combined maximum of $250 every two years. Eyeglass lenses have a copay of $0-$153, while contact lenses and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay, but Medicare dental services have a 20% coinsurance and require prior authorization. Orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance ranges from 0% to 20%. Other Medicare Part B drugs and Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance that ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care MO-1 (PPO C-SNP) plan, but require prior authorization. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have no copay and 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $25 copay, and lab services with no copay. Radiological services are also covered, including diagnostic radiological services with a copay up to $200 and therapeutic radiological services with at least 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care MO-1 (PPO C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Complete Care MO-1 (PPO C-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; there is no coinsurance. Additional days beyond Medicare-covered for SNF, and Non-Medicare-covered stays for SNF, are not covered.
Other Services See details
Under "Other Services," the UHC Complete Care MO-1 (PPO C-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, while the Meal Benefit also has no copay and requires prior authorization. Acupuncture, Dual Eligible SNPs, 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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