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UHC Dual Complete WA-S2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WA-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 WA-S2 (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-S2 (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 King, Pierce, and Snohomish Counties. 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-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 WA-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 WA-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 WA-S2 (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
Health deductible: same as Medicare's Part B deductible.
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 $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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 $13900.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $13900.00 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-S2 (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-S2 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies and through standard mail order. For Tier 2 generic and Tier 3 preferred brand drugs, the plan charges a 25% coinsurance for standard pharmacy and standard mail-order fills. For higher-tier medications, Tier 4 non-preferred drugs and Tier 5 specialty tier drugs both require a 25% coinsurance for a one-month supply. This clear cost-sharing structure allows you to easily anticipate your out-of-pocket costs at standard pharmacies and through mail order. Understanding these tier-based coinsurance rates helps you maximize your Medicare drug benefits.
Additional Benefits
The UHC Dual Complete WA-S2 (PPO D-SNP) offers robust medical coverage with many essential services featuring no copay, though certain treatments require coinsurance or specific copayments. For instance, inpatient hospital stays carry a $1,890 copay per admission with no coinsurance, while emergency services require a $115 copay that is waived upon admission. Most outpatient care, primary doctor visits, and specialist consultations require no copay, though you may pay up to a 20% coinsurance depending on the specific service. This plan also includes valuable supplemental benefits, such as dental and vision care with no copay and generous annual allowances for eyewear and comprehensive dental services. Routine hearing exams and hearing aids are covered with no copay, featuring up to a $2,200 allowance every two years. Additionally, members can access home health services, skilled nursing facility care, and select transportation benefits with no copay.
Inpatient Hospital See details
UHC Dual Complete WA-S2 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,890 copay per admission and no coinsurance, subject to prior authorization. While unlimited additional acute care days are covered with no copay, additional psychiatric days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete WA-S2 (PPO D-SNP) with no copays, though coinsurance ranges from no coinsurance up to 20% depending on the service and prior authorization may be required. Covered benefits include outpatient hospital, ambulatory surgical center, and substance abuse services, while observation and outpatient blood services carry a 20% coinsurance with no deductible.
Partial Hospitalization See details
UHC Dual Complete WA-S2 (PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
UHC Dual Complete WA-S2 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance, offering up to 36 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete WA-S2 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $40 copay 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 WA-S2 (PPO D-SNP) covers primary care, specialist visits, and mental health services with no copay and 0% to 20% coinsurance. Physical, occupational, and speech therapies are covered with no copay and 20% coinsurance, while chiropractic benefits are partially covered as other chiropractic services are not covered. Telehealth and opioid treatment services are fully covered with no copay and no coinsurance.
Preventive Services See details
UHC Dual Complete WA-S2 (PPO D-SNP) provides partially covered preventive services, offering annual physicals, fitness benefits, and kidney disease education with no copay and no coinsurance, while digital rectal exams and EKGs require 20% coinsurance. Sub-services that are not covered under this plan include health education, personal emergency response systems (PERS), in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Dual Complete WA-S2 (PPO D-SNP) partially covers hearing services, offering annual routine exams with no copay and 20% coinsurance, and prescription and OTC hearing aids with no copay and no coinsurance up to a $2,200 maximum every two years. However, fitting and evaluation for hearing aids, along with 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-S2 (PPO D-SNP) with no copay, no coinsurance, and no deductible for covered options. The plan covers one routine eye exam yearly and provides a $200 annual limit for select eyewear like contact lenses, eyeglass lenses, and frames, while other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete WA-S2 (PPO D-SNP), featuring Medicare-covered dental care with no copay and 20% coinsurance. Other preventive and comprehensive dental services are covered with no copay and no coinsurance up to a $2,500 annual maximum, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete WA-S2 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and range from no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WA-S2 (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete WA-S2 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, though manufacturer limits apply and prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Dual Complete WA-S2 (PPO D-SNP) with prior authorization. Lab services have no copay, diagnostic tests require a copay and 20% coinsurance, and radiological services require no copay, with 20% coinsurance for therapeutic and X-ray services and no coinsurance for diagnostic radiology.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete WA-S2 (PPO D-SNP) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Dual Complete WA-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 WA-S2 (PPO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. While the plan allows for admission without a prior three-day inpatient hospital stay, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete WA-S2 (PPO D-SNP) with no copay and no coinsurance for acupuncture (limited to 12 treatments per year), over-the-counter items, and chronic illness meal benefits with prior authorization. Unspecified other services and highly integrated services for dual eligible SNPs are not covered under this plan.
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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