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UHC Complete Care SC-1 (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care SC-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 SC-1 (PPO C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care SC-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 South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care SC-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 SC-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 SC-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 SC-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:
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Drug Coverage
The UHC Complete Care SC-1 (PPO C-SNP) Medicare plan features an annual prescription drug deductible of $440. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled at standard pharmacies or through standard mail order. This no-copay benefit applies to both 1-month and 3-month supplies, providing savings on common generic prescriptions. For higher-tier medications, cost-sharing is structured as a percentage of the drug cost rather than a flat copayment. Tier 3 preferred brand drugs have a 22% coinsurance, while Tier 4 non-preferred drugs require a 46% coinsurance. Specialty medications in Tier 5 carry a 28% coinsurance for a 1-month supply at standard pharmacies and standard mail order.
Additional Benefits
The UHC Complete Care SC-1 (PPO C-SNP) plan offers robust core medical coverage, featuring no copays or coinsurance for primary care visits, telehealth, and annual preventive care. Specialized care is highly affordable, with specialist doctor visits requiring a copay of only up to $45, and no copay for lab services or diagnostic radiology. For emergency and hospital care, members pay a $130 copay for emergency room visits and a $455 daily copay for the first few days of inpatient hospital stays, with no copays required for longer stays. In addition to medical essentials, this plan provides valuable everyday health benefits, including routine dental, vision, and hearing exams with no copays. Members also benefit from a $1,000 annual dental allowance, no-copay routine transportation for up to 36 one-way trips per year, and no-copay over-the-counter items. Essential medical needs like dialysis and durable medical equipment are covered with no copay and a standard 20% coinsurance.
Inpatient Hospital See details
UHC Complete Care SC-1 (PPO C-SNP) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Medicare-covered acute stays carry a $455 copay for days 1 through 6 and no copay for days 7 and beyond, while psychiatric stays require a $455 copay for days 1 through 5 and no copay for days 6 through 90, excluding hospital upgrades and non-Medicare-covered stays.
Outpatient Services See details
UHC Complete Care SC-1 (PPO C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $455, observation services carry a $455 daily copay, and outpatient substance abuse sessions require a copay of $0 to $25, with prior authorization required for most services.
Partial Hospitalization See details
UHC Complete Care SC-1 (PPO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Complete Care SC-1 (PPO C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Complete Care SC-1 (PPO C-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care SC-1 (PPO C-SNP) provides primary care, telehealth, and routine podiatry services with no copay and no coinsurance, while specialist visits require a $0 to $45 copay and no coinsurance. Physical, occupational, and speech therapies have a $45 copay with no coinsurance, mental health services have copays ranging from $0 to $25 with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
UHC Complete Care SC-1 (PPO C-SNP) covers preventive services, including annual physical exams, kidney disease education, and diabetes self-management training, with no copay and no coinsurance. Additional preventive benefits are partially covered, providing fitness benefits and home safety devices with no copay and no coinsurance, while services like health education, personal emergency response systems, and medical nutrition therapy are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care SC-1 (PPO C-SNP) with no deductibles or coinsurance, including no copay for annual routine hearing exams. While fitting evaluations and inner, outer, or over-the-ear prescription hearing aids are not covered, other prescription and OTC hearing aids are covered with copays ranging from $199.00 to $1,249.00 for up to two devices per year.
Vision Services See details
Vision Services are partially covered by UHC Complete Care SC-1 (PPO C-SNP) with no deductible, offering one routine eye exam per year and contact lenses or frames every two years with no copay and no coinsurance. Eyeglass lenses are covered with no coinsurance and a copay of $0 to $153 up to a combined $150 eyewear limit every two years, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Complete Care SC-1 (PPO C-SNP) offers partially covered dental services up to a $1,000 annual limit, excluding implant services and orthodontics which are not covered. Preventive care is provided with no copay and no coinsurance, while Medicare-covered dental services have no copay and 20% coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care SC-1 (PPO C-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under UHC Complete Care SC-1 (PPO C-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical Equipment is covered by UHC Complete Care SC-1 (PPO C-SNP), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic equipment and supplies from specified manufacturers are covered with no copay and no coinsurance, with prior authorization required for all medical equipment categories.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by UHC Complete Care SC-1 (PPO C-SNP) with prior authorization required, featuring no coinsurance and a $50 copay for diagnostic procedures, alongside no copay or coinsurance for lab services. Radiological services require a $25 copay for outpatient X-rays, no copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
UHC Complete Care SC-1 (PPO C-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by UHC Complete Care SC-1 (PPO C-SNP) with no coinsurance, though some services are covered while specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care SC-1 (PPO C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring no prior 3-day hospital stay, although prior authorization is required. There is no copay for days 1 to 20 and a $218 daily copay for days 21 to 100, though additional days beyond the 100-day limit are not covered.
Other Services See details
UHC Complete Care SC-1 (PPO C-SNP) provides partial coverage for other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
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