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UHC Dual Complete WV-S2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WV-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 WV-S2 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WV-S2 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of West Virginia. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete WV-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 WV-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 WV-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 WV-S2 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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:
Sign up for UHC Dual Complete WV-S2 (PPO D-SNP)
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Drug Coverage
The prescription drug coverage for the UHC Dual Complete WV-S2 (PPO D-SNP) plan includes an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for one-month and three-month supplies at standard pharmacies or via standard mail order. For all other drug tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance applies to standard pharmacy and standard mail order options during the initial coverage phase.
Additional Benefits
The UHC Dual Complete WV-S2 (PPO D-SNP) plan offers robust healthcare coverage with many essential services featuring no copay, including primary care visits, outpatient services, and home health care. Inpatient hospital stays require a $2,060 copay per stay with no coinsurance, while emergency room visits carry a $115 copay that is waived upon admission. For other medical needs like dialysis, durable medical equipment, and ambulance services, members will generally pay a 20% coinsurance with no copay. Supplemental care is highly accessible, featuring a dental benefit with a $2,500 annual limit and no copay or coinsurance for most preventive and comprehensive services. Vision benefits include routine exams and a $200 annual eyewear allowance with no copay or coinsurance, while hearing benefits cover up to two hearing aids every two years with no copay. Furthermore, members can receive over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete WV-S2 (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $2,060 copayment per stay and no coinsurance, though prior authorization is required. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, while unlimited additional acute care days are covered with no copay.
Outpatient Services See details
Outpatient services are covered under UHC Dual Complete WV-S2 (PPO D-SNP) with no copay, although prior authorization is required for many of these services. Depending on the specific service, coinsurance ranges from no coinsurance up to 20% for outpatient hospital, ambulatory surgical center, and substance abuse services, while outpatient blood services require a 20% coinsurance with no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete WV-S2 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete WV-S2 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. For transportation benefits, some services are covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
UHC Dual Complete WV-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 feature a copay ranging from $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits under UHC Dual Complete WV-S2 (PPO D-SNP) are covered with no copays, with coinsurance ranging from 0% to 20% for provider visits, mental health, and therapy services. Telehealth and opioid treatment services have no copay and no coinsurance, and while some chiropractic services are covered, routine chiropractic care and other chiropractic services are not.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete WV-S2 (PPO D-SNP), offering annual physicals, kidney education, and fitness benefits with no copay and no coinsurance, while digital rectal exams and EKGs require a 20% coinsurance. Sub-services including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete WV-S2 (PPO D-SNP), featuring one annual routine hearing exam with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Up to two OTC or prescription hearing aids are covered every two years with no copay and no coinsurance (up to a $2,200 maximum for prescription aids), though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete WV-S2 (PPO D-SNP) with no copay, no coinsurance, and no deductible for covered services. This plan includes one routine eye exam per year and a $200 annual limit for 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 WV-S2 (PPO D-SNP), featuring a $2,500 annual maximum benefit 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 services have no copay and no coinsurance, except for implant services and orthodontics which are not covered.
Home Infusion bundled Services See details
UHC Dual Complete WV-S2 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, are covered with coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WV-S2 (PPO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete WV-S2 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies feature no copay but are limited to specified manufacturers, and prior authorization is required for most of these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete WV-S2 (PPO D-SNP) and require prior authorization. Lab services have no copay, diagnostic radiological services have no copay or coinsurance, and diagnostic procedures, therapeutic radiology, and outpatient X-rays require a 20% coinsurance, with diagnostic procedures also requiring a copay.
Home Health Services See details
UHC Dual Complete WV-S2 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Dual Complete WV-S2 (PPO D-SNP) with no copay and prior authorization required, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete WV-S2 (PPO D-SNP) with no copay and no coinsurance, as additional days beyond the Medicare-covered limit are not covered. Prior authorization is required for these services, though the plan conveniently allows for admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services under the UHC Dual Complete WV-S2 (PPO D-SNP) are partially covered, featuring over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered, and the meal benefit requires prior authorization.
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