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UHC Dual Complete OK-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete OK-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 OK-S001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete OK-S001 (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 Oklahoma. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete OK-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 OK-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 OK-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 OK-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.20. 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 OK-S001 (PPO D-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for 1-month and 3-month supplies filled at standard pharmacies or through standard mail order. Tier 2 generic drugs require a 25% coinsurance for both 1-month and 3-month fills. For Tier 3 preferred brand drugs, members pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies or standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for a 1-month supply.
Additional Benefits
The UHC Dual Complete OK-S001 (PPO D-SNP) plan offers comprehensive medical coverage with many services featuring no copay, including primary and specialist care, outpatient services, and home health care. While inpatient hospital stays require a $2,025 copay per stay, emergency services have a $115 copay, which is waived upon admission. Most outpatient and diagnostic services, including dialysis, medical equipment, and routine chiropractic care, feature no copays but may require a 20% coinsurance. This plan also provides robust supplemental benefits, including dental coverage up to a $2,000 annual limit and vision care with a $200 annual allowance for eyewear, both with no copays or coinsurance. Additionally, members can access up to 24 free one-way transportation trips per year, over-the-counter items at no cost, and up to $2,200 in prescription hearing aids every two years with no copay and no coinsurance. These extra benefits help ensure that your essential health, wellness, and daily living needs are covered with minimal out-of-pocket costs.
Inpatient Hospital See details
Inpatient hospital care is partially covered by UHC Dual Complete OK-S001 (PPO D-SNP), requiring a $2,025 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. While unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers outpatient services with no copay, though coinsurance ranges from no coinsurance to 20% for outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services also feature no copay and 20% coinsurance with no deductible, and prior authorization is required for most of these outpatient benefits.
Partial Hospitalization See details
Partial hospitalization services are covered under the UHC Dual Complete OK-S001 (PPO D-SNP) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance, offering up to 24 one-way trips per year to plan-approved locations, while trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from no copay up to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
Primary care benefits under UHC Dual Complete OK-S001 (PPO D-SNP) are covered with no copays and coinsurance ranging from no coinsurance to 20% for services such as PCP, specialist, mental health, and physical therapy. Chiropractic services are partially covered, as other chiropractic services are not covered, while routine chiropractic care is covered with no copay and 20% coinsurance for up to 12 visits yearly. Telehealth and opioid treatment services are covered with no copay and no coinsurance.
Preventive Services See details
Preventive services are covered by UHC Dual Complete OK-S001 (PPO D-SNP), with annual physical exams, kidney disease education, and fitness benefits offered at no copay and no coinsurance. Additional preventive benefits are partially covered; weight management, caregiver support, and home safety modifications have no copay, while health education, personal emergency response systems, and medical nutrition therapy are not covered. Medicare-covered digital rectal exams and EKGs require a 20% coinsurance, whereas diabetes self-management training is available with no copay.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete OK-S001 (PPO D-SNP), which offers one annual routine hearing exam with no copay and 20% coinsurance, alongside OTC hearing aids and up to $2,200 in prescription hearing aids every two years with no copay and no coinsurance. Fitting and evaluation exams, as well as 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 Dual Complete OK-S001 (PPO D-SNP) with no copay and no coinsurance, featuring one routine eye exam per year and a combined $200 annual allowance for contacts, eyeglass lenses, and frames. Other eye exam services, eyeglasses (lenses and frames) packages, and upgrades are not covered.
Dental Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) offers partially covered dental services, featuring Medicare-covered dental care with no copay and 20% coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a $2,000 annual limit, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete OK-S001 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by UHC Dual Complete OK-S001 (PPO D-SNP) with prior authorization required. Diagnostic radiology features no copay and no coinsurance, and lab services have no copay, while diagnostic tests require a copay and 20% minimum coinsurance, and therapeutic radiology and outpatient X-rays require a 20% minimum coinsurance with no copay.
Home Health Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers home health services 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 OK-S001 (PPO D-SNP) with no copay and prior authorization required, though some services are not covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete OK-S001 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay or coinsurance, and does not require a prior three-day hospital stay. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete OK-S001 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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