A non-government entity
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 2026, 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 State of Missouri. This plan received an overall rating of 4.5 out of 5 stars in 2026.
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.
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 $440.00 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:
Sign up for UHC Complete Care MO-1 (PPO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Complete Care MO-1 (PPO C-SNP) prescription drug plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for 1-month or 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs require an $8 copay for a 1-month supply at standard pharmacies, but members can receive a 3-month supply with no copay when using preferred mail order. For brand-name and higher-tier medications, costs are based on coinsurance during the initial coverage phase. Tier 3 preferred brand drugs require a 21% coinsurance for both 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 4 non-preferred drugs carry a 44% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The UHC Complete Care MO-1 (PPO C-SNP) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, telehealth, home health care, and annual preventive services. For hospital care, inpatient stays require a $395 copay for the first several days and no copay for subsequent days, while emergency room visits carry a $130 copay. Outpatient services and specialist visits are also highly accessible, with costs ranging from no copay up to a $395 copay depending on the service. Routine dental, vision, and hearing exams are fully covered with no copay and no coinsurance, though specialized hardware like hearing aids and prescription lenses require copays. Durable medical equipment, dialysis, and Medicare Part B drugs generally feature a 20% coinsurance with no copay. Additionally, the plan offers no copay and no coinsurance for diabetic supplies, chronic illness meals, and over-the-counter items.
Inpatient Hospital See details
UHC Complete Care MO-1 (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $395 copay for days 1 through 6 of acute stays and days 1 through 5 of psychiatric stays, with no copay for subsequent days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Complete Care MO-1 (PPO C-SNP) with no coinsurance, including ambulatory surgical center and blood services at no copay. Medicare-covered outpatient hospital services require a copay of $0 to $395, observation services cost a $395 daily copay, and outpatient substance abuse services carry a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Complete Care MO-1 (PPO C-SNP) with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
UHC Complete Care MO-1 (PPO C-SNP) offers partial coverage for Ambulance and Transportation Services, featuring a $290 copay and no coinsurance for both ground and air ambulance services, which require prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Complete Care MO-1 (PPO C-SNP) covers emergency services with a $130 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 $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under UHC Complete Care MO-1 (PPO C-SNP) are covered with no copay and no coinsurance for primary care, telehealth, and podiatry services, though chiropractic services are not covered. Specialist visits range from a $0 to $40 copay, physical and occupational therapy require a $40 copay, and mental health sessions range from a $0 to $25 copay, all with no coinsurance.
Preventive Services See details
Preventive services are partially covered by UHC Complete Care MO-1 (PPO C-SNP) with no copay and no coinsurance for covered benefits like annual physicals, kidney disease education, fitness benefits, and home safety devices. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care MO-1 (PPO C-SNP), offering one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation services are not covered. The plan also covers up to two prescription or OTC hearing aids per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by UHC Complete Care MO-1 (PPO C-SNP) with no deductibles, no coinsurance, and no copay for one annual routine exam, contact lenses, and eyeglass frames, while other eye exams, upgrades, and combined eyeglasses are not covered. Eyeglass lenses require a copay of $0.00 to $153.00 with no coinsurance, and there is a combined maximum eyewear benefit of $150 every two years.
Dental Services See details
Dental services are partially covered by UHC Complete Care MO-1 (PPO C-SNP), offering preventive care like exams, cleanings, and fluoride with no copay and no coinsurance. Medicare-covered dental services have no copay and a 20% coinsurance, but comprehensive options such as restorative, endodontics, periodontics, prosthodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
UHC Complete Care MO-1 (PPO C-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care MO-1 (PPO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care MO-1 (PPO C-SNP), featuring no copay and a 20% coinsurance for durable medical equipment and prosthetics. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, though manufacturer limitations apply and prior authorization is required.
Diagnostic and Radiological Services See details
UHC Complete Care MO-1 (PPO C-SNP) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests require a $50 copay, outpatient X-rays require a $25 copay, and therapeutic radiological services have a 20% coinsurance, while lab services and diagnostic radiological services are offered with no copay and no coinsurance.
Home Health Services See details
UHC Complete Care MO-1 (PPO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Complete Care MO-1 (PPO C-SNP) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care MO-1 (PPO C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day inpatient hospital stay is not needed before admission, but additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
UHC Complete Care MO-1 (PPO C-SNP) offers partial coverage for other services, featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other additional services are not covered, and prior authorization is required for the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved