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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 $1.30. 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 $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:
Sign up for UHC Dual Complete ME-S1 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete ME-S1 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for a 3-month supply through standard mail order. This ensures that essential generic medications remain highly affordable and accessible. For other prescription tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will typically pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy fills and standard mail order services for both 1-month and 3-month supplies where applicable.
Additional Benefits
The UHC Dual Complete ME-S1 (PPO D-SNP) plan offers comprehensive medical coverage with many essential services requiring no copay. Primary care, specialist visits, and outpatient hospital services feature no copay, though coinsurance can range up to 20%. Inpatient hospital stays require a copay of $2,165 for acute care and $2,080 for psychiatric care, while emergency room visits have a $115 copay that is waived if you are admitted. This plan also includes valuable everyday health benefits, such as routine vision exams and a $250 annual eyewear allowance with no copay or coinsurance. Prescription hearing aids are covered up to $2,200 every two years with no copay, and home health care, skilled nursing facility stays, and select over-the-counter items are also available with no copays or coinsurance. Additionally, members can access up to 36 one-way trips per year to plan-approved locations at no cost.
Inpatient Hospital See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers inpatient hospital services with no coinsurance, featuring a $2,165 copay per acute stay and a $2,080 copay per psychiatric stay. Additional acute days are covered with no copay, but upgrades and non-Medicare-covered stays 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. Covered outpatient hospital, ambulatory surgical center, substance abuse, and blood services feature no copay and coinsurance ranging from no coinsurance up to 20%.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete ME-S1 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete ME-S1 (PPO D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance rides. Transportation benefits are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay or coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan 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 copay and no coinsurance.
Primary Care See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while physical, occupational, and speech therapies require no copay and 20% coinsurance. Telehealth and opioid treatment services are fully covered with no copay and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under UHC Dual Complete ME-S1 (PPO D-SNP), with no copays or coinsurance for annual physicals, kidney disease education, glaucoma screenings, diabetes training, fitness, weight management, caregiver support, in-home assistance, and safety devices. A 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, smoking cessation counseling, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete ME-S1 (PPO D-SNP), featuring one routine hearing exam annually with no copay and a 20% coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are covered up to $2,200 every two years with no copay and no coinsurance, but inner ear, outer ear, and over the ear types are excluded. Up to two OTC hearing aids are also covered every two years with no copay and no coinsurance.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete ME-S1 (PPO D-SNP) with no copay and no coinsurance, providing one routine eye exam annually and up to a $250 yearly limit for contact lenses, eyeglass lenses, and frames. Prior authorization is required for exams, and certain services such as upgrades, other eye exams, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete ME-S1 (PPO D-SNP) partially covers dental services, providing Medicare-covered dental care with no copay and a 20% coinsurance, which requires prior authorization. Routine and comprehensive sub-services, including oral exams, cleanings, x-rays, fluoride, restorative care, endodontics, periodontics, implants, prosthodontics, and orthodontic services, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete ME-S1 (PPO D-SNP) with no copay and no coinsurance, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin carries a $35 copay and ranges from no coinsurance to 20% coinsurance.
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, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with prior authorization required. These covered benefits feature no copay and a 20% coinsurance, except for diabetic supplies which are covered with no copay.
Diagnostic and Radiological Services See details
UHC Dual Complete ME-S1 (PPO D-SNP) covers diagnostic and radiological services, which require prior authorization. Diagnostic tests require a copay and 20% coinsurance, while lab services have no copay. Diagnostic radiology is available with no copay and no coinsurance, whereas therapeutic radiology and outpatient X-rays require no copay and a 20% coinsurance.
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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by UHC Dual Complete ME-S1 (PPO D-SNP) with no copay and require prior authorization, although some services are covered while others are not. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete ME-S1 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required. This benefit allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete ME-S1 (PPO D-SNP), which offers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though acupuncture is not covered. Prior authorization is required for the meal benefit, and the OTC benefit includes coverage for nicotine replacement therapy and naloxone.
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