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UHC Dual Complete SC-V001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete SC-V001 (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 SC-V001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete SC-V001 (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 South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete SC-V001 (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 SC-V001 (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 SC-V001 (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 SC-V001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $2.30. 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 $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 Dual Complete SC-V001 (PPO D-SNP) plan has an annual prescription drug deductible of $615. Beneficiaries pay no copay for Tier 1 preferred generic drugs, whether filling a 1-month or 3-month supply at a standard pharmacy, or a 3-month supply through standard mail order. This coverage provides an affordable way to access your essential preferred generic medications. For other prescription tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan charges a 25% coinsurance. This 25% cost-sharing rate applies to standard pharmacy fills as well as standard mail order services.
Additional Benefits
The UHC Dual Complete SC-V001 (PPO D-SNP) plan offers robust coverage with no copays or coinsurance for primary care visits, routine preventive services, and home health care. For inpatient hospital stays, members pay a $495 copay for the first few days and no copay for additional days, with no coinsurance required. Outpatient services and specialist visits feature low to no copays, while emergency room visits carry a $130 copay that is waived upon hospital admission. Ancillary benefits include dental and vision care with no deductibles, no copays for routine exams, and coinsurance ranging up to 50% for comprehensive dental services. Prescription hearing aids are available with copays starting at $199, and the plan covers up to 24 one-way transportation trips per year with no copay. Additionally, durable medical equipment, dialysis services, and many Medicare Part B drugs require 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by UHC Dual Complete SC-V001 (PPO D-SNP) with no coinsurance, as upgrades and non-Medicare-covered stays are not covered. Medicare-covered acute stays require a $495 copay for days 1 through 5 with no copay for additional days, while psychiatric stays require a $495 copay for days 1 through 4 with no copay for days 5 through 90.
Outpatient Services See details
Outpatient services covered by UHC Dual Complete SC-V001 (PPO D-SNP) feature no coinsurance, with ambulatory surgical center and blood services also requiring no copay. Outpatient hospital and observation services require copays ranging from $0 to $495 per day, while outpatient substance abuse sessions have copays between $0 and $25, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete SC-V001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) covers ground and air ambulance services with a $290 copay and no coinsurance, 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 SC-V001 (PPO D-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 feature a copay of up to $50 and 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 the UHC Dual Complete SC-V001 (PPO D-SNP) plan feature no copays and no coinsurance for primary care and telehealth visits, while specialist, therapy, and mental health services have copays ranging from $0 to $30 with no coinsurance. Chiropractic services are partially covered because routine chiropractic care is not covered.
Preventive Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) preventive services are partially covered with no copay and no coinsurance for covered care, including annual physicals, fitness benefits, and kidney disease education. However, the plan does not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) offers partially covered hearing services with no coinsurance. Routine hearing exams have no copay for one visit per year, but fitting and evaluation exams are not covered. Up to two prescription hearing aids per year are covered with a $199.00 to $1,249.00 copay, and up to two OTC hearing aids are covered with a $199.00 to $829.00 copay, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete SC-V001 (PPO D-SNP), featuring no deductible, no coinsurance, and no copay for one routine eye exam each year. Covered eyewear has no coinsurance and a $150 combined maximum limit every two years, with no copay for contact lenses and eyeglass frames and a $0 to $153 copay for eyeglass lenses, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) partially covers dental services, offering preventive care with no copay and no coinsurance, Medicare-covered dental with no copay and 20% coinsurance, and comprehensive care with no copay and 50% coinsurance up to a $1,000 annual limit. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered under UHC Dual Complete SC-V001 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete SC-V001 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete SC-V001 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are also covered with no copay, and prior authorization is required for most equipment and supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete SC-V001 (PPO D-SNP) with prior authorization required. Outpatient lab services have no copay and no coinsurance, diagnostic procedures and tests require a $50 copay and no coinsurance, and diagnostic radiology copays start at $0. Outpatient X-rays have a $25 copay, and therapeutic radiological services require 20% coinsurance.
Home Health Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization is required. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete SC-V001 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior 3-day inpatient hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
UHC Dual Complete SC-V001 (PPO D-SNP) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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