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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 2025, 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 out of 5 stars in 2025.
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 $49.80. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $2.00. 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 OK-S001 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy, you will pay $49.80 for Part D.
Additional Benefits
The UHC Dual Complete OK-S001 (PPO D-SNP) plan offers a variety of benefits, including coverage for inpatient hospital stays with a $1,515 copay, outpatient services with varying coinsurance, and emergency services with a $110 copay. The plan also covers primary care, preventive, vision, and dental services, often with no copay or coinsurance. Additional benefits include home health services with no copay, ambulance and transportation services with 20% coinsurance, and hearing services with varying costs. This plan provides coverage for a wide range of healthcare needs, but does not cover certain services like cardiac rehabilitation, orthodontic, and implant services.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, the copay for a Medicare-covered stay is $1,515.00, and additional days (91-999) have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital Psychiatric, the copay for a Medicare-covered stay is $1,515.00, and additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a coinsurance between 0% and 20%, observation services have a 20% coinsurance, and outpatient blood services have a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services have a coinsurance between 0% and 20% for individual sessions, and a 20% coinsurance for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete OK-S001 (PPO D-SNP) plan. The plan has a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with 20% coinsurance for both ground and air ambulance services. Transportation services to a plan-approved health-related location are covered with no copay, with up to 36 one-way trips per year via taxi or medical transport. 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 by the UHC Dual Complete OK-S001 (PPO D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, and Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete OK-S001 (PPO D-SNP) plan covers primary care physician services with a coinsurance between 0% and 20%, and routine chiropractic care with no copay and no coinsurance. The plan also covers additional telehealth benefits with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, as well as an annual physical exam with no copay. Additional preventive services are covered with no copay, while glaucoma screening, diabetes self-management training, and barium enemas are covered with no copay. Digital rectal exams and EKG following Welcome Visit have a 20% coinsurance. However, health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, 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.
Hearing Services See details
Hearing services include coverage for hearing exams with a minimum 20% coinsurance for routine hearing exams, as well as prescription hearing aids with a maximum benefit of $2200 per year, and OTC hearing aids with no copay. Fitting/Evaluation for Hearing Aid, 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 OK-S001 (PPO D-SNP) plan covers vision services including eye exams, routine eye exams, contact lenses, eyeglass lenses and eyeglass frames 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, and other services like oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery with no copay. Orthodontic and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UHC Dual Complete OK-S001 (PPO D-SNP) plan, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OK-S001 (PPO D-SNP) plan, with prior authorization required. You will pay 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Medical supplies and Prosthetic Devices have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20% and a minimum coinsurance of 0% and 20%, respectively. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete OK-S001 (PPO D-SNP) plan with no copay and no coinsurance, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, but require prior authorization. The plan follows the Medicare-defined cost share for tier 1, but the specific copay and coinsurance amounts are not provided.
Other Services See details
The UHC Dual Complete OK-S001 (PPO D-SNP) plan covers Over-the-Counter (OTC) items with no copay. However, acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management, institution for mental disease services for individuals 65 or older, services in an intermediate care facility for individuals with intellectual disabilities, 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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