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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 2026, 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 4.5 out of 5 stars in 2026.
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 $41.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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:
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Drug Coverage
The UHC Dual Complete SD-S2 (PPO D-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, there is 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. For Tier 2 generic drugs and Tier 3 preferred brand drugs, you will pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete SD-S2 (PPO D-SNP) offers comprehensive medical coverage featuring no copays for primary and specialist care visits, with coinsurance ranging from 0% to 20%. While inpatient hospital stays require a $2,010 copay per stay with no coinsurance, outpatient services, home health, and skilled nursing facility care are covered with no copays. Emergency services incur a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Additional benefits include comprehensive dental coverage with a $2,000 annual maximum and vision services that feature no copay, no coinsurance, and a $200 yearly eyewear allowance. Hearing care provides up to a $2,200 allowance for hearing aids every two years, and eligible members can access up to 36 free one-way transportation trips annually to approved health locations. The plan also covers over-the-counter items and select preventive services with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete SD-S2 (PPO D-SNP) partially covers inpatient hospital services, requiring a $2,010 copay per stay and no coinsurance for Medicare-covered acute and psychiatric stays. Prior authorization is required, and while unlimited additional acute care days are covered with no copay, the plan does not cover upgrades, non-Medicare-covered stays, or additional psychiatric days.
Outpatient Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete SD-S2 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete SD-S2 (PPO D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services, which require prior authorization. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services have a copay ranging from no copay 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 SD-S2 (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 programs are provided with no copay and no coinsurance, but chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete SD-S2 (PPO D-SNP), featuring no copays and no coinsurance for annual physicals, kidney disease education, fitness benefits, and home safety devices, while digital rectal exams and EKGs require a 20% coinsurance with no copay. Sub-services not covered under this plan 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 benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers routine hearing exams once yearly with no copay and a 20% coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are partially covered with no copay and no coinsurance, with prescription aids excluding inner ear, outer ear, and over-the-ear types up to a $2,200 maximum limit every two years.
Vision Services See details
Vision services are partially covered by UHC Dual Complete SD-S2 (PPO D-SNP) with no deductible, no copay, and no coinsurance, offering one annual routine eye exam and a $200 yearly allowance for contact lenses, eyeglass lenses, and frames. Other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) offers partially covered dental services with an annual maximum benefit of $2,000 for both in-network and out-of-network care. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services feature no copay and no coinsurance, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete SD-S2 (PPO D-SNP) with no copay, although prior authorization and step therapy are required. Covered Medicare Part B drugs, including chemotherapy and radiation, have a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete SD-S2 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most items.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete SD-S2 (PPO D-SNP) with prior authorization required, featuring no copays for lab and radiological services. Diagnostic radiological services require no coinsurance, while diagnostic procedures, therapeutic radiology, and outpatient X-rays incur a 20% coinsurance, with diagnostic procedures also requiring a copay.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete SD-S2 (PPO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers cardiac rehabilitation services with no copay, although prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete SD-S2 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because, while it allows for admission without a prior three-day inpatient hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete SD-S2 (PPO D-SNP) partially covers other services, providing over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture and highly integrated services are not covered under this benefit, and prior authorization is required for the meal benefit.
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