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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 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete WA-V2 (PPO D-SNP) is a PPO D-SNP plan offered by Sierra Health and Life Insurance Company, Inc. available for the 2026 plan year to people living in Select Counties in Washington. This plan received an overall rating of 4.5 out of 5 stars in 2026.
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 $10.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6700.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $10100.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 WA-V2 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The UHC Dual Complete WA-V2 (PPO D-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as for a 3-month supply through standard mail order. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to 1-month and 3-month supplies for Tiers 2 and 3, and to 1-month supplies for Tiers 4 and 5 through standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete WA-V2 (PPO D-SNP) plan offers robust coverage for essential medical services, often with no coinsurance and low out-of-pocket costs. Members benefit from no copay for primary care visits, telehealth, annual physicals, and home health services, while specialist visits require a low copay of up to $50. Emergency care is available with a $130 copay, and inpatient hospital stays require a $510 daily copay for the first few days before transitioning to no copay. This plan also includes valuable everyday benefits like routine dental, vision, and hearing care, featuring no copay for routine exams and preventive dental care up to a $1,000 annual limit. Routine transportation is covered with no copay for up to 24 one-way trips per year to plan-approved locations. Additionally, members pay no copay and a 20% coinsurance for durable medical equipment and dialysis services, making managing chronic conditions highly affordable.
Inpatient Hospital See details
Inpatient hospital care is partially covered by UHC Dual Complete WA-V2 (PPO D-SNP) with no coinsurance, requiring a $510 daily copay for days 1 to 5 of acute stays (no copay for days 6 to 999) and a $510 daily copay for days 1 to 4 of psychiatric stays (no copay for days 5 to 90). Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $510 for outpatient hospital and observation services, and $0 to $25 for outpatient substance abuse sessions. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, though prior authorization is required for most services.
Partial Hospitalization See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete WA-V2 (PPO D-SNP), featuring a $290 copay and no coinsurance for both ground and air ambulance services. Routine transportation is partially covered, offering up to 24 one-way trips per year to plan-approved health locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency care, urgent care, and emergency transportation are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits for UHC Dual Complete WA-V2 (PPO D-SNP) feature no copay and no coinsurance for primary care doctor visits and telehealth. Specialist visits, mental health, and therapy services require copays ranging from $0 to $50 with no coinsurance, while chiropractic care is partially covered because other chiropractic services are excluded.
Preventive Services See details
Preventive services are covered by UHC Dual Complete WA-V2 (PPO D-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness, weight management, and home safety devices, but health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) partially covers hearing services with no coinsurance, offering one routine hearing exam annually with no copay and up to two hearing aids per year. Copays range from $199 to $1,249 for covered prescription hearing aids and $199 to $829 for OTC hearing aids, but fitting and evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete WA-V2 (PPO D-SNP) with no deductible and no coinsurance, including no copay for one routine eye exam per year. Covered eyewear features contact lenses and eyeglass frames with no copay, and eyeglass lenses with a copay of $0.00 to $153.00 under a combined $150 limit every two years, though other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) offers partially covered dental services, featuring no copay and no coinsurance for preventive care up to a $1,000 annual limit, and no copay with 20% coinsurance for Medicare-covered dental. Comprehensive dental services are covered with no copay and 50% coinsurance, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Dual Complete WA-V2 (PPO D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WA-V2 (PPO D-SNP) plan with no copay and a 20% coinsurance, subject to prior authorization requirements.
Medical Equipment See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with no copay and a 20% coinsurance for most items. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers diagnostic services with no coinsurance, featuring no copay for lab services and a $45 copay for diagnostic procedures. Covered radiological services include diagnostic radiological services with no copay, outpatient X-rays with a $25 copay, and therapeutic radiological services with a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete WA-V2 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete WA-V2 (PPO D-SNP) plan, as none of the sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete WA-V2 (PPO D-SNP) covers acupuncture, over-the-counter (OTC) items, and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is limited to 12 treatments per year, and the meal benefit requires prior authorization.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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