UHC Dual Complete MI-Y1 (HMO D-SNP)

Benefits Summary and Overview

This page is a benefits summary and overview of key plan information for UHC Dual Complete MI-Y1 (HMO 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 MI-Y1 (HMO 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 MI-Y1 (HMO D-SNP) is a HMO D-SNP plan offered by Unitedhealthcare Community Plan, Inc. available for the 2026 plan year to people living in Select Counties in Michigan. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that UHC Dual Complete MI-Y1 (HMO 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 MI-Y1 (HMO 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.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about UHC Dual Complete MI-Y1 (HMO 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 MI-Y1 (HMO D-SNP), the main costs are as follows:

Monthly Premium

The Monthly Premium for this plan is $6.80. 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: information not available.

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.

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:

Regular visits to your primary care doctor are covered and will have a coinsurance of 0% - 20%.

Specialist Visits:

Visits to specialists are covered and will have a coinsurance of 0% - 20%. Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care are covered and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for UHC Dual Complete MI-Y1 (HMO D-SNP)

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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 IconDrug Coverage

The UHC Dual Complete MI-Y1 (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are fully covered with no copay for 1-month and 3-month supplies at standard pharmacies, as well as 3-month mail orders. This ensures that your most common maintenance medications are highly affordable. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a consistent 25% coinsurance. This 25% coinsurance rate applies to 1-month and 3-month supplies at standard pharmacies and standard mail order services, depending on the specific tier. This straightforward cost-sharing structure helps you easily plan for your monthly prescription drug expenses.

Additional Benefits IconAdditional Benefits

The UHC Dual Complete MI-Y1 (HMO D-SNP) plan offers comprehensive medical coverage with many services featuring no copay, though coinsurance and prior authorization often apply. For primary care, specialist visits, outpatient services, and home health care, you will pay no copay, though select services may carry up to a 20% coinsurance. Inpatient hospital stays require a $2,045 copayment per stay with no coinsurance, while emergency room visits have a $115 copay that is waived if you are admitted. You can also access key supplemental benefits, including vision exams with a $200 annual eyewear allowance and routine hearing exams with a $2,500 hearing aid allowance every two years, both featuring no copay. Additionally, the plan covers up to 84 one-way transportation trips, Medicare-covered dental care, and durable medical equipment with no copay, although a 20% coinsurance applies to dental and equipment. Over-the-counter items, home health, and skilled nursing facility stays are also covered with no copay or coinsurance.

Inpatient Hospital See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with a $2,045 copayment per stay, no coinsurance, and required prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.

Outpatient Services See details

Outpatient services are covered by UHC Dual Complete MI-Y1 (HMO D-SNP) with no copays, though coinsurance and prior authorization are generally required. Covered outpatient hospital, ambulatory surgical center, and substance abuse services feature no copay and coinsurance ranging from no coinsurance to 20%, while outpatient blood services have no copay, no deductible, and a 20% coinsurance.

Partial Hospitalization See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.

Ambulance and Transportation Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers emergency ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance, providing up to 84 one-way trips per year to plan-approved locations, though trips to any health-related location are not covered.

Emergency Services See details

UHC Dual Complete MI-Y1 (HMO 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 copay and no coinsurance.

Primary Care See details

Primary care and specialist services under UHC Dual Complete MI-Y1 (HMO D-SNP) are covered with no copay and 0% to 20% coinsurance, while telehealth and opioid treatment programs offer no copay or coinsurance. Physical, occupational, speech, and podiatry therapies are covered with no copay and 20% coinsurance, whereas chiropractic services are not covered in practice.

Preventive Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, and select supplemental benefits like fitness programs. However, a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs, and several services—including health education, personal emergency response systems, and medical nutrition therapy—are not covered.

Hearing Services See details

Hearing Services are partially covered by UHC Dual Complete MI-Y1 (HMO D-SNP), offering one routine hearing exam per year with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Covered prescription hearing aids (up to $2,500 every two years) and OTC hearing aids have no copay and no coinsurance, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.

Vision Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) provides partially covered vision services with no copay, no coinsurance, and no deductible, including one routine eye exam yearly and a $200 annual allowance for contact lenses, eyeglass lenses, or frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.

Dental Services See details

Dental services are partially covered under the UHC Dual Complete MI-Y1 (HMO D-SNP) plan, which offers Medicare-covered dental benefits with no copay and a 20% coinsurance, though prior authorization is required. Routine and comprehensive services—including oral exams, cleanings, x-rays, preventive care, restorative services, endodontics, periodontics, prosthodontics, implants, and oral surgery—are not covered.

Home Infusion bundled Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Medicare Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.

Dialysis Services See details

Dialysis Services are covered under the UHC Dual Complete MI-Y1 (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.

Medical Equipment See details

Medical equipment benefits under UHC Dual Complete MI-Y1 (HMO D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these services.

Diagnostic and Radiological Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures and tests require a copay and a minimum 20% coinsurance, while lab services have no copay but carry coinsurance. Radiological services have no copay, with therapeutic radiology and outpatient X-rays requiring a minimum 20% coinsurance, and diagnostic radiology requiring no coinsurance.

Home Health Services See details

UHC Dual Complete MI-Y1 (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to receive this covered benefit.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are covered under UHC Dual Complete MI-Y1 (HMO D-SNP) with no copay and prior authorization, although some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require 20% coinsurance.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete MI-Y1 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required. The plan covers admissions without requiring a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.

Other Services See details

UHC Dual Complete MI-Y1 (HMO 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 is not covered under this benefit, and prior authorization is required for the meal benefit.

Plan Providers IconPlan 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.

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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

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