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UHC Dual Complete SD-S2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete SD-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 SD-S2 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete SD-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 Dakota. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete SD-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 SD-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 SD-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 SD-S2 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $45.90. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.10. 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 SD-S2 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy type until your total drug costs reach $2,000. Once you reach $2,000 in total drug costs, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs.
Additional Benefits
The UHC Dual Complete SD-S2 (PPO D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services with varying copays and coinsurance. You'll find no copays for preventive services like annual physical exams, and also no copays for hearing exams, eyewear, and over-the-counter items. The plan also covers ambulance services with 20% coinsurance, and transportation services with no copay for up to 36 one-way trips per year. Dental services have no copay for certain services, and home health services have no copay as well.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but with a copay of $1670 per admission or stay for Medicare-covered stays, and the Additional Days for Inpatient Hospital-Acute has no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered. Outpatient Hospital Services have a coinsurance of 0% - 20%, Observation Services have a 20% coinsurance, Ambulatory Surgical Center (ASC) 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 by the UHC Dual Complete SD-S2 (PPO D-SNP) plan. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay for up to 36 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Dual Complete SD-S2 (PPO D-SNP) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Dual Complete SD-S2 (PPO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services and physician specialist services have a coinsurance of 0% - 20%, chiropractic services have a 20% coinsurance, and occupational therapy services have a coinsurance of 0% - 20%. Mental health specialty services, psychiatric services, and other health care professional services have a coinsurance of 0% - 20%. Podiatry services have a 20% coinsurance and no copay, while physical therapy and speech-language pathology services have a coinsurance of 0% - 20%. Additional telehealth benefits and opioid treatment program services have no copay.
Preventive Services See details
Preventive services include coverage for Medicare-covered preventive services, annual physical exams with no copay, and additional preventive services with a copay. The plan also covers kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, or counseling services.
Hearing Services See details
Hearing Services for UHC Dual Complete SD-S2 (PPO D-SNP) include hearing exams with no copay, and prescription hearing aids (all types) with a $0 copay. Additionally, OTC hearing aids are covered with no copay. Fitting/Evaluation for Hearing Aid, and Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
Under the UHC Dual Complete SD-S2 (PPO D-SNP) plan, eye exams and eyewear are covered. Eye exams have no copay, and routine eye exams are limited to one per year. Eyewear has no copay, and contact lenses, eyeglass lenses, and eyeglass frames are covered, with a combined maximum benefit of $300 per year. 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. Other services like Oral Exams, Dental X-Rays, and Prophylaxis (Cleaning) have no copay, and a maximum benefit of $2000 per year. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete SD-S2 (PPO D-SNP) plan, with a coinsurance between 20% and 20%. Prior authorization is required for coverage.
Medical Equipment See details
Medical Equipment is covered by the UHC Dual Complete SD-S2 (PPO D-SNP) plan, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance; Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20% and Lab Services with no copay. Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are covered with a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete SD-S2 (PPO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete SD-S2 (PPO D-SNP) plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered. The plan requires prior authorization and charges the Medicare-defined cost share for tier 1, but the copay information is not available.
Other Services See details
The UHC Dual Complete SD-S2 (PPO D-SNP) plan covers over-the-counter items with no copay and meal benefits with no copay, but requires 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.
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