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UHC Dual Complete SC-S2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete SC-S2 (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 SC-S2 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete SC-S2 (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 South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete SC-S2 (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 SC-S2 (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 SC-S2 (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 SC-S2 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $33.90. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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 $9250.00 (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 $9250.00 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 prescription drug coverage for the UHC Dual Complete SC-S2 (PPO D-SNP) plan includes an annual drug deductible of $615. For Tier 1 preferred generic medications, there is no copay for a 1-month or 3-month supply at a standard pharmacy, or for a 3-month supply via standard mail order. This ensures zero out-of-pocket costs for your most common essential prescriptions. For higher-tier medications, the plan transitions to a coinsurance model where you pay 25% of the drug cost. This 25% coinsurance applies to Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs filled at standard pharmacies or through standard mail order. These straightforward cost-sharing tiers make it easy to plan your healthcare budget.
Additional Benefits
The UHC Dual Complete SC-S2 (PPO D-SNP) offers comprehensive medical coverage featuring no copays for primary care, specialist visits, outpatient hospital services, and home health care, though coinsurance up to 20% may apply to some services. Inpatient hospital stays require no coinsurance but carry a $1,695 copay per admission, while emergency room visits have a $115 copay that is waived if admitted. Most routine preventive services, telehealth, and diagnostic lab tests are fully covered with no copay and no coinsurance. For supplemental care, the plan provides vision and hearing benefits, including no-copay routine eye exams with a $100 annual eyewear allowance, and hearing aid coverage up to $1,500 every two years with no copay or coinsurance. Durable medical equipment, dialysis, and Medicare-covered dental services are available with no copay and a 20% coinsurance. Additionally, members can access over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete SC-S2 (PPO D-SNP) inpatient hospital services are partially covered, requiring no coinsurance and a $1,695 copayment per admission for Medicare-covered acute and psychiatric stays. While unlimited additional acute care days are covered with no copay, additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers outpatient services with no copay, though coinsurance ranges from no coinsurance up to 20% depending on the service. These covered benefits include outpatient hospital, ambulatory surgical center, substance abuse, and blood services with no deductible, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete SC-S2 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers Medicare-approved ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Routine transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered under the UHC Dual Complete SC-S2 (PPO D-SNP) plan with a $115 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services require a copay of $0 to $40 and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers primary care, specialist, and mental health services with no copay and 0% to 20% coinsurance, while physical and occupational therapies require no copay and 20% coinsurance. Telehealth and opioid treatment are covered with no copay and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers annual physical exams, kidney disease education, and diabetes self-management with no copay and no coinsurance, while digital rectal exams and post-welcome visit EKGs require a 20% coinsurance. Additional preventive services are partially covered, offering fitness benefits and in-home support with no copay or coinsurance, though sub-services such as health education, personal emergency response systems, and nutritional counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete SC-S2 (PPO D-SNP) with no deductible, offering one routine hearing exam annually with a 20% coinsurance and no copay, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to a $1,500 limit every two years, but 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 SC-S2 (PPO D-SNP) with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and a $100 annual combined limit for contact lenses, eyeglass lenses, and frames, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by UHC Dual Complete SC-S2 (PPO D-SNP), with covered Medicare dental services requiring no copay and a 20% coinsurance, subject to prior authorization. Routine and restorative services—including oral exams, cleanings, x-rays, fluoride treatments, and orthodontic services—are not covered.
Home Infusion bundled Services See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete SC-S2 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete SC-S2 (PPO D-SNP) with no copays across all services, though prior authorization is required. A 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete SC-S2 (PPO D-SNP) with prior authorization, offering lab services with no copay and diagnostic radiology with no copay and no coinsurance. Diagnostic procedures require a copay and 20% coinsurance, while therapeutic radiology and outpatient X-rays have no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete SC-S2 (PPO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered by UHC Dual Complete SC-S2 (PPO D-SNP) with no copay and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete SC-S2 (PPO D-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, though prior authorization is required and Medicare-defined copays apply. The plan does not require a prior three-day inpatient hospital stay for admission, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete SC-S2 (PPO D-SNP), featuring no copay and no coinsurance for over-the-counter (OTC) items and chronic illness meal benefits, though prior authorization is required for meals and acupuncture is not covered.
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