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UHC Dual Complete IN-S3 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete IN-S3 (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 IN-S3 (PPO D-SNP) in 2025, please refer to our full plan details page.
This summary reflects 2025 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete IN-S3 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for the 2025 plan year to people living in State of Indiana. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete IN-S3 (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 IN-S3 (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 IN-S3 (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 IN-S3 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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 Maximum Out-Of-Pocket cost of $9350.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9350.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $14000.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 Dual Complete IN-S3 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The UHC Dual Complete IN-S3 (PPO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible is met, the plan will cover your drug costs. If you qualify for the low-income subsidy, your monthly premium for Part D drugs will be $49.60. Once your total drug costs reach $2000.00, you will enter the catastrophic coverage phase. In this phase, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete IN-S3 (PPO D-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including primary care, vision exams, home health, and diagnostic services, while others have a coinsurance between 0% and 20%. Emergency services have a $110 copay, and inpatient hospital stays have a $1645 copay per admission. Additional benefits include coverage for hearing aids up to $3200 per year, dental services with no copay for many services, and transportation services with no copay for approved health-related trips. This plan also covers outpatient services, partial hospitalization, and medical equipment with varying cost-sharing, and requires prior authorization for some services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization; Inpatient Hospital-Acute has a copay of $1645 per admission or stay for Medicare-covered stays, and additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric has a copay of $1645 per admission or stay for Medicare-covered stays, and additional days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a coinsurance of 0% - 20%, observation services with a 20% coinsurance, and ambulatory surgical center (ASC) services with a coinsurance between 0% and 20%. Outpatient substance abuse services, including individual sessions with a 0% - 20% coinsurance and group sessions with a 20% coinsurance, are also covered, along with outpatient blood services that have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Complete IN-S3 (PPO D-SNP) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including ground and air ambulance services, are covered by the UHC Dual Complete IN-S3 (PPO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered, with a limit of 48 one-way trips per year, and no copay. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete IN-S3 (PPO D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
Under the UHC Dual Complete IN-S3 (PPO D-SNP) plan, primary care physician services, occupational therapy, physician specialist services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services have no copay. Chiropractic services have a 20% coinsurance, and routine foot care has a 20% coinsurance. Mental health and psychiatric services have coinsurance between 0% and 20% depending on the type of session.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, including the annual physical exam with no copay, and additional preventive services with a copay depending on the service. Other preventive services include a 20% coinsurance for EKG following Welcome Visit and digital rectal exams.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered, with a maximum plan benefit of $3200 per year, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete IN-S3 (PPO D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and routine eye exams have no copay, and eyewear has no copay with a combined maximum benefit of $300 every year for both in-network and out-of-network services. Contact lenses, eyeglass lenses, and eyeglass frames are covered, but eyeglasses and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. 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 are covered with no copay. However, this plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete IN-S3 (PPO D-SNP) plan. The plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment includes Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medicare-covered Medical Supplies 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, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete IN-S3 (PPO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare coverage and non-Medicare-covered stays are not covered. The plan requires prior authorization and charges the Medicare-defined cost share for tier 1, with copay information available elsewhere in the plan details.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and a Meal Benefit, both with no copay; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, 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. The Meal Benefit requires prior authorization.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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