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UHC Dual Complete RI-V001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete RI-V001 (HMO-POS 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 RI-V001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete RI-V001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Rhode Island. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete RI-V001 (HMO-POS 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 RI-V001 (HMO-POS 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 RI-V001 (HMO-POS 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 RI-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $12.00. 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 $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 Maximum Out-Of-Pocket cost of $4900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 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:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy (LIS), you will pay $12.00 for Part D drugs. During the initial coverage phase, after you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Many services have no copay, including primary care visits, preventive services, vision exams, and home health services. However, some services like inpatient hospital stays and emergency services have copays, and some services like ambulance and diagnostic procedures have copays or coinsurance. This plan covers a wide range of services, including hearing aids, dental, and medical equipment, with specific copays or coinsurance amounts. The plan also includes coverage for outpatient services, mental health, and transportation, offering a comprehensive approach to healthcare.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you pay a $395 copay for days 1-6, and no copay for days 7-90, with no coinsurance; additional days have no copay. For Inpatient Hospital Psychiatric, you pay a $395 copay for days 1-5, and no copay for days 6-90, with no coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services with the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan include coverage for all outpatient hospital services, with a copay between $0 and $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have a copay between $0 and $10 for individual sessions and a $5 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by UHC Dual Complete RI-V001 (HMO-POS D-SNP). Ground and air ambulance services have a $275 copay, while transportation services to a plan-approved health-related location have no copay for up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $20, and Physician Specialist Services with a copay between $0 and $20. This plan also covers Mental Health Specialty Services, Podiatry Services with a $20 copay, Other Health Care Professional with a copay between $0 and $20, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $20, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams with no copay, and additional preventive services. Additional preventive services include Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, with no copay. Some services, such as Health Education, are not covered.
Hearing Services See details
Hearing Services includes coverage for hearing exams with no copay, prescription hearing aids (all types) with a copay between $199 and $1249, and OTC hearing aids with a copay between $99 and $829. Routine hearing exams are covered with no copay, but fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
The UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan covers vision services, including eye exams with no copay and eyewear. Eyeglasses (lenses and frames) are not covered, but contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay.
Dental Services See details
Dental Services with the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan include coverage for Medicare Dental Services with 20% coinsurance, and other dental services with a $2,500 annual maximum benefit. Oral exams, dental X-rays, other diagnostic services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services are covered with no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, Oral and Maxillofacial Surgery are covered with no copay. Prosthodontics, removable and Prosthodontics, fixed are covered with 0% to 50% coinsurance. Orthodontic Services are covered under Diagnostic and Preventive Dental. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan, but require prior authorization. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and authorization is required. Prosthetics/Medical Supplies has a 20% coinsurance for Medicare-covered services. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests have a copay of $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, Therapeutic Radiological Services have no copay, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete RI-V001 (HMO-POS 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 specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete RI-V001 (HMO-POS D-SNP) plan, with a $0 copay for days 1-20 and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay, but acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered. Nicotine Replacement Therapy (NRT) and Naloxone are offered as Part C OTC benefits.
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