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UHC Dual Complete WA-V2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WA-V2 (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 WA-V2 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete WA-V2 (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 Washington. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete WA-V2 (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 WA-V2 (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 WA-V2 (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 WA-V2 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.20. 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:
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Drug Coverage
The UHC Dual Complete WA-V2 (PPO D-SNP) plan has a $590 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. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $26.20.
Additional Benefits
The UHC Dual Complete WA-V2 (PPO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays that range from $0 to $450. The plan also includes coverage for ambulance services with a copay, and transportation services with no copay for a limited number of trips. The plan provides coverage for primary care, preventive services, hearing, vision, and dental services, with many services having no copay. Additionally, the plan covers home health services, and other services like acupuncture and over-the-counter items with no copay. Some services like skilled nursing facilities and dialysis services have copays or coinsurance associated with them.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $450 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a $450 copay for days 1-4, and no copay for days 5-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay and no coinsurance. 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 copay between $0 and $450, observation services have a $450 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete WA-V2 (PPO D-SNP) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
The UHC Dual Complete WA-V2 (PPO D-SNP) plan covers ambulance services with a $290 copay for both ground and air ambulance services, with no coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, but are limited to 24 one-way trips per year. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete WA-V2 (PPO D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete WA-V2 (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 and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, and additional telehealth benefits have no copay. Physician specialist services have a copay between $0 and $50, while occupational therapy services have a copay up to $35. Mental health specialty services, podiatry services, other health care professional, psychiatric services, and opioid treatment program services have varying copays. Physical therapy and speech-language pathology services have a copay between $0 and $35.
Preventive Services See details
Preventive services include coverage for Annual Physical Exams with no copay, and Additional Preventive Services with a copay for Fitness Benefits, Home and Bathroom Safety Devices, and Modifications. Other services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, and more, are not covered. Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner, outer, or over the ear are not covered.
Vision Services See details
The UHC Dual Complete WA-V2 (PPO D-SNP) plan covers vision services, including eye exams with no copay and eyewear with a combined maximum of $250 every two years. Contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete WA-V2 (PPO D-SNP) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, with no copay for most services. Medicare dental services have a 20% coinsurance, and prosthodontics and fixed prosthodontics have a 0-50% coinsurance. Orthodontic services are covered under Diagnostic and Preventive Dental, but implants and orthodontics are not covered.
Home Infusion bundled Services See details
The UHC Dual Complete WA-V2 (PPO D-SNP) plan covers Home Infusion bundled Services with prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WA-V2 (PPO D-SNP) plan, but prior authorization is required. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with varying copays and coinsurance depending on the service. 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 and tests with a $45 copay, and lab services with no copay. Diagnostic radiological services have a copay up to $250, therapeutic radiological services have a 20% coinsurance, and outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete WA-V2 (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 covered, but the plan does not cover any of the sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Dual Complete WA-V2 (PPO D-SNP) plan. There is no copay for days 1-20, but there is a $203 copay for days 21-100; additional days beyond Medicare-covered SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Dual Complete WA-V2 (PPO D-SNP) plan covers acupuncture with no copay for up to 12 treatments per year. Over-the-counter items are covered with no copay, including nicotine replacement therapy and Naloxone, though not all drugs on the CMS OTC list are covered. The plan also offers a meal benefit for chronic illness with no copay, and some other services are not covered.
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