A non-government entity
UHC Dual Complete IN-D001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete IN-D001 (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 IN-D001 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete IN-D001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in State of Indiana. The overall rating for this plan is not yet available for 2026.
It's important to know that UHC Dual Complete IN-D001 (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 IN-D001 (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 IN-D001 (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 IN-D001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 IN-D001 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The prescription drug coverage for the UHC Dual Complete IN-D001 (PPO D-SNP) plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for 1-month and 3-month supplies at standard pharmacies, as well as no copay for 3-month standard mail orders. For Tier 2 generic and Tier 3 preferred brand drugs, you will pay a 25% coinsurance for both 1-month and 3-month supplies at standard pharmacies and standard mail orders. Tier 4 non-preferred drugs and Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply filled at standard pharmacies or through standard mail order.
Additional Benefits
The UHC Dual Complete IN-D001 (PPO D-SNP) plan offers extensive medical coverage with no copay for primary care, specialist visits, and outpatient services, though some of these services may carry up to a 20% coinsurance. For hospital care, inpatient acute stays require a $2,165 copay and psychiatric stays require a $2,080 copay, both with no coinsurance, while skilled nursing and home health services are covered with no copay or coinsurance. Emergency room care is subject to a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits like routine vision exams with a $200 annual eyewear allowance and preventive dental care, both provided with no copay or coinsurance. Members also benefit from no copay on routine hearing exams and up to $1,500 every two years for prescription hearing aids, though a 20% coinsurance applies to the hearing exams. Additionally, the plan covers up to 24 one-way transportation trips per year and over-the-counter items with no copay or coinsurance, while medical equipment and dialysis require a 20% coinsurance and no copay.
Inpatient Hospital See details
UHC Dual Complete IN-D001 (PPO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,165 copay per acute stay and a $2,080 copay per psychiatric stay, both subject to prior authorization. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) covers outpatient services with no copay, though coinsurance ranges from no coinsurance up to 20% depending on the service. Prior authorization is required for outpatient hospital, ambulatory surgical center, substance abuse, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete IN-D001 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete IN-D001 (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 or coinsurance.
Primary Care See details
UHC Dual Complete IN-D001 (PPO D-SNP) offers primary care and specialist services with no copay and 0% to 20% coinsurance. While routine chiropractic care is not covered, other benefits like physical therapy, occupational therapy, and telehealth are covered with no copay and coinsurance ranging from 0% to 20%, with telehealth requiring no coinsurance.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete IN-D001 (PPO D-SNP), featuring no copay and no coinsurance for annual physicals, kidney disease education, fitness benefits, weight management, and in-home support. However, digital rectal exams and EKGs following a welcome visit require a 20% coinsurance, and several sub-services—including health education, personal emergency response systems, and nutritional counseling—are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete IN-D001 (PPO D-SNP), which offers routine hearing exams once yearly with no copay, no deductible, and a 20% coinsurance, though fitting and evaluations are not covered. Prescription hearing aids (up to $1,500 every two years) and OTC hearing aids are covered with no copay and no coinsurance, but 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 IN-D001 (PPO D-SNP) with no deductible, copay, or coinsurance for covered services, which include one routine eye exam yearly and a $200 annual limit for contact lenses, eyeglass lenses, and frames. Other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) offers partially covered dental services, featuring Medicare-covered dental care with no copay and a 20% coinsurance, plus preventive services like exams and cleanings with no copay and no coinsurance. Other diagnostic, restorative, endodontic, periodontic, prosthodontic, oral surgery, implant, and orthodontic services are not covered.
Home Infusion bundled Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and radiation, require no coinsurance up to 20% coinsurance, while Part B insulin drugs carry a $35 copay and no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete IN-D001 (PPO D-SNP) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete IN-D001 (PPO D-SNP) with no copay and 20% coinsurance for durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, although manufacturer limitations apply, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Dual Complete IN-D001 (PPO D-SNP) with prior authorization, offering diagnostic radiological services with no copay and no coinsurance, and lab services with no copay. Medicare-covered diagnostic procedures require both a copayment and 20% coinsurance, while therapeutic radiological and outpatient X-ray services require a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete IN-D001 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) provides Cardiac Rehabilitation Services with no copay, but prior authorization is required and only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete IN-D001 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. While a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete IN-D001 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for the meal benefit, while acupuncture and other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved