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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 2025, 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 Select counties in Maine. This plan received an overall rating of 4 out of 5 stars in 2025.
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 $33.80. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.30. 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 ME-S1 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, you will pay $33.80. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Dual Complete ME-S1 (PPO D-SNP) plan offers a range of benefits, including inpatient and outpatient hospital services with varying cost-sharing, and coverage for emergency and urgently needed services. This plan provides coverage for a variety of services, including primary care, preventive services, hearing, vision, dental, home health, and dialysis services. Many services have no copay, while others include coinsurance. Additional benefits include hearing aids, vision care, dental services, and medical equipment. The plan also includes coverage for home health services and offers coverage for over-the-counter items and a meal benefit with no copay. However, this plan does not cover certain services such as cardiac rehabilitation and other services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including acute and psychiatric care, with a copay of $1,805 per admission or stay for Medicare-covered stays and no coinsurance. Additional days for Inpatient Hospital-Acute have no copay and no coinsurance for days 91-999, while non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a coinsurance of 0% - 20%, observation services have a 20% coinsurance, ambulatory surgical center services have a coinsurance of 0% - 20%, individual sessions for outpatient substance abuse have a coinsurance of 0% - 20%, group sessions for outpatient substance abuse have a 20% coinsurance, and outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground and air ambulance services with a 20% coinsurance, and transportation services to a plan-approved health-related location with no copay. 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 under the UHC Dual Complete ME-S1 (PPO D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $45 and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services have a 0% to 20% coinsurance, while Chiropractic Services and Routine Foot Care have a 20% coinsurance. Additional Telehealth Benefits and Opioid Treatment Program Services have no copay.
Preventive Services See details
The UHC Dual Complete ME-S1 (PPO D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services include Fitness Benefit with no copay, while other services like Health Education, In-Home Safety Assessment, and others are not covered. Other Preventive Services have a 20% coinsurance for EKG following Welcome Visit and Digital Rectal Exams.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams are covered with no copay and at most 20% coinsurance, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a maximum benefit of $2200 every year, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete ME-S1 (PPO D-SNP) plan covers vision services, including routine eye exams with no copay, and eyewear with a combined maximum of $400 per year. Contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, while eyeglasses (lenses and frames) 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, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery are covered with no copay. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance, while Medical Supplies have 20% coinsurance. Diabetic Equipment includes Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete ME-S1 (PPO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete ME-S1 (PPO D-SNP) plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered SNF stays, nor does it cover non-Medicare-covered SNF stays.
Other Services See details
Under "Other Services", 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. Over-the-Counter (OTC) Items and Meal Benefit are covered with no copay.
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