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UHC Dual Complete RI-S3 (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-S3 (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-S3 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete RI-S3 (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-S3 (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-S3 (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-S3 (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-S3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $52.50. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.70. 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 $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 $9350.00 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-S3 (HMO-POS D-SNP) plan has a deductible of $590.00. After the deductible, you pay the costs for your drugs, which depend on the specific drug tier and pharmacy. Once your total drug costs reach $2000.00, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D drugs is $52.50. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for your Part D covered drugs, but you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The UHC Dual Complete RI-S3 (HMO-POS D-SNP) plan provides coverage for a wide range of services with varying cost-sharing. Inpatient hospital stays require a $1,440 copay, while emergency services have a $110 copay (waived if admitted to the hospital). Outpatient services, primary care, and diagnostic services often involve coinsurance between 0% and 20%. This plan also offers additional benefits, such as no copay for preventive services like an annual physical and hearing exams, as well as dental services with no copay. Transportation services have no copay for up to 72 one-way trips per year, and home health services have no copay and no coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute with a $1,440 copay per admission or stay, and Additional Days for Inpatient Hospital-Acute with no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric benefits are covered with a $1,440 copay per admission or stay, while Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a coinsurance between 0% and 20%, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a coinsurance between 0% and 20%, Outpatient Substance Abuse Services with a coinsurance between 0% and 20% depending on the service, and Outpatient Blood Services with a 20% coinsurance. Prior authorization is required for many of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered with no copay for 72 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the UHC Dual Complete RI-S3 (HMO-POS D-SNP) plan. For emergency services, you will pay a $110 copay, and there is no coinsurance; however, the copay is waived if you are admitted to the hospital within 24 hours. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic services have a 20% coinsurance, and routine chiropractic care is not covered. For Individual and Group Sessions for Mental Health and Psychiatric Services, coinsurance ranges from 0% to 20%. Podiatry services have a 20% coinsurance for routine foot care, and the plan covers up to 6 visits per year. Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services, including fitness benefits and home and bathroom safety devices and modifications. Glaucoma screenings, Diabetes Self-Management Training, and Barium Enemas have no copay. Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Remote Access Technologies.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, and no copay. Prescription hearing aids are covered with no copay, and OTC hearing aids have no copay. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and contact lenses. There is no copay for eye exams, contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and other dental services with a $4,000 maximum benefit per year, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, other preventive services, restorative services, and more with no copay. Orthodontic services and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, you will pay a $35 copay and 0-20% coinsurance; other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance of 0-20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization. You are responsible for 20% coinsurance.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with no copay and coinsurance, as well as Diabetic Equipment, covered with coinsurance and copay depending on the service. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of up to 20% (with a minimum of 0%), Therapeutic Radiological Services with a coinsurance of up to 20% (with a minimum of 20%), and Outpatient X-Ray Services with a coinsurance of up to 20% (with a minimum of 20%). Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete RI-S3 (HMO-POS D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete RI-S3 (HMO-POS D-SNP) plan. Specifically, the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not provide Skilled Nursing Facility Services as a supplemental benefit under Part C, and additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required, and the copay is based on the Medicare-defined cost share for tier 1.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items and Meal Benefit, both with no copay, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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