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UHC Dual Complete ME-S1 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete ME-S1 (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 ME-S1 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete ME-S1 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Maine. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete ME-S1 (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 ME-S1 (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 ME-S1 (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 ME-S1 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 $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 ME-S1 (PPO D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one-month or three-month supplies at standard pharmacies, as well as for three-month standard mail-order prescriptions. For Tier 2 generic and Tier 3 preferred brand drugs, the plan requires a 25% coinsurance for both one-month and three-month supplies. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance for one-month supplies at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete ME-S1 (PPO D-SNP) offers comprehensive medical coverage with no copays for primary care, outpatient care, and home health services. Inpatient hospital stays require a $2020.00 copayment per stay with no coinsurance, while emergency room visits carry a $115 copay that is waived upon admission. Many outpatient, diagnostic, and medical equipment services feature no copays, though they may require up to 20% coinsurance. This plan also provides robust dental, vision, and hearing benefits, including a $2,500 annual limit for dental care and a $200 yearly allowance for eyewear with no copays or coinsurance. Routine hearing exams and hearing aids are covered with no copay, offering up to a $2,200 aid allowance every two years. Additionally, members can access up to 36 free one-way transportation trips to approved health locations, alongside skilled nursing care and over-the-counter items with no copays or coinsurance.
Inpatient Hospital See details
UHC Dual Complete ME-S1 (PPO D-SNP) inpatient hospital benefits are partially covered, requiring a $2020.00 copayment per stay and no coinsurance for covered acute and psychiatric admissions, with prior authorization required. 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 ME-S1 (PPO D-SNP) covers outpatient services with no copays, though prior authorization is required and coinsurance ranges from no coinsurance up to 20%. Covered options include outpatient hospital care, ambulatory surgical center visits, outpatient substance abuse sessions, and blood services.
Partial Hospitalization See details
UHC Dual Complete ME-S1 (PPO D-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 Dual Complete ME-S1 (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 36 one-way trips per year to plan-approved health-related locations, though trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete ME-S1 (PPO D-SNP) 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 $0 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 services covered by UHC Dual Complete ME-S1 (PPO D-SNP) feature no copays, with coinsurance ranging from no coinsurance to 20% for primary care, specialist, therapy, and mental health visits. Additional telehealth and opioid treatment services are covered with no copays and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive Services under the UHC Dual Complete ME-S1 (PPO D-SNP) are partially covered, with key benefits like annual physicals, fitness programs, and kidney disease education requiring no copay and no coinsurance. However, digital rectal exams and post-welcome visit EKGs require a 20% coinsurance, and several options—including health education, nutritional therapy, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete ME-S1 (PPO D-SNP), offering one annual routine hearing exam with no copay and a 20% coinsurance, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to a $2,200 maximum every two years, 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 ME-S1 (PPO D-SNP) with no copay, no coinsurance, and no deductible, providing one routine eye exam yearly and a $200 annual allowance for contact lenses, eyeglass lenses, and frames. Other eye exams, packaged eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete ME-S1 (PPO D-SNP), with implant services and orthodontics not covered under the plan. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive services feature no copay and no coinsurance up to a $2,500 annual maximum.
Home Infusion bundled Services See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B drugs for these services, including chemotherapy and insulin, feature no coinsurance to 20% coinsurance, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment benefits under UHC Dual Complete ME-S1 (PPO D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies feature no copay, while diabetic therapeutic shoes and inserts carry a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers diagnostic and radiological services with prior authorization, featuring no copay for lab services and diagnostic radiology, which also has no coinsurance. Medicare-covered diagnostic procedures, therapeutic radiology, and outpatient X-rays incur a 20% coinsurance, with copays also applying to diagnostic procedures.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers some cardiac rehabilitation services with no copay, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required and additional days beyond Medicare-covered limits are not covered. The plan also allows for admission to a skilled nursing facility without requiring a prior three-day inpatient hospital stay.
Other Services See details
Other Services under the UHC Dual Complete ME-S1 (PPO D-SNP) plan are partially covered, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture is not covered under this benefit.
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