A non-government entity
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 $0.20. 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:
Sign up for UHC Dual Complete ME-S1 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete ME-S1 (PPO D-SNP) plan has a $590.00 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2000.00. If you qualify for the low-income subsidy (LIS), you will pay $33.80 per month for Part D. Once your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for covered Part D drugs.
Additional Benefits
The UHC Dual Complete ME-S1 (PPO D-SNP) plan offers a range of benefits with varying costs. Hospital stays require a $1775 copay per admission, while outpatient services and primary care have coinsurance between 0% and 20%. Emergency services have a copay, but urgent and worldwide emergency services have no copay. Preventive services like annual checkups have no copay, and the plan also covers hearing and vision services, including routine exams and eyewear, with no copay for most services. Dental services include no copay for preventive care, and the plan covers home health services with no copay. Additional benefits include OTC items and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric with a copay of $1775 per admission or stay, with additional days for Inpatient Hospital-Acute at no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for 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%, while observation services have a 20% coinsurance. Ambulatory Surgical Center (ASC) Services have a coinsurance between 0% and 20%. Individual sessions for outpatient substance abuse have a coinsurance between 0% and 20%, and group sessions have a 20% coinsurance. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. The plan has a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete ME-S1 (PPO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay, with up to 48 one-way trips per year. 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 by the UHC Dual Complete ME-S1 (PPO D-SNP) plan. Emergency Services has a $110 copay, while Urgently Needed Services has a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services (Individual Sessions and Group Sessions), Physical Therapy and Speech-Language Pathology Services, and Psychiatric Services (Individual Sessions and Group Sessions) are covered, with coinsurance ranging from 0% to 20%, and some services require prior authorization. Chiropractic Services and Other Health Care Professional services are covered with 20% coinsurance and prior authorization, while Routine Chiropractic Care is not covered. Podiatry Services are covered with 20% coinsurance for Routine Foot Care, and Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive Services include a $0 copay for an annual physical exam, and additional preventive services, including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, and Kidney Disease Education Services, are covered with a $0 copay. Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas have a $0 copay, while Digital Rectal Exams and EKG following Welcome Visit have 20% coinsurance. Other services like Health Education, and counseling are not covered.
Hearing Services See details
Hearing Services include coverage for routine hearing exams with no copay and a 20% coinsurance, and OTC hearing aids with no copay. Prescription Hearing Aids are covered with no copay. Fitting/Evaluation for Hearing Aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The UHC Dual Complete ME-S1 (PPO D-SNP) plan covers vision services, including routine eye exams with no copay. The plan also covers eyewear, including contact lenses, eyeglass lenses, and eyeglass frames with no copay, and has a combined maximum benefit of $300 per year for eyewear. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services with the UHC Dual Complete ME-S1 (PPO D-SNP) plan cover Medicare Dental Services with 20% coinsurance, and other services like oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. The plan has a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% for all covered drugs.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and prior authorization required, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with varying cost-sharing depending on the service. Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%. Lab Services have no copay.
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. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete ME-S1 (PPO D-SNP) plan. The plan does not cover 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
The UHC Dual Complete ME-S1 (PPO D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. Over-the-counter items have no copay, while meal benefits also have no copay and require prior authorization. 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved