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UHC Dual Complete GA-D001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete GA-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 GA-D001 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete GA-D001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Georgia. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete GA-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 GA-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 GA-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 GA-D001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 combined Maximum Out-Of-Pocket cost of $14000.00 (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 $14000.00 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:
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Drug Coverage
The UHC Dual Complete GA-D001 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you will pay $38.60. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete GA-D001 (PPO D-SNP) plan offers comprehensive coverage with varying costs. Inpatient hospital stays have a $2,000 copay per admission, while emergency services have a $110 copay. The plan also includes benefits like no copay for preventive services, routine hearing and vision exams, dental services, and home health services. Other services have coinsurance between 0% and 20%, and the plan includes coverage for transportation, outpatient services, and medical equipment, among other benefits.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the UHC Dual Complete GA-D001 (PPO D-SNP) plan. For Medicare-covered stays, there is a $2,000 copay per admission or stay, and additional days for Inpatient Hospital-Acute have no copay; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as 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 of 0% to 20%, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a coinsurance between 0% and 20%, Individual Sessions for Outpatient Substance Abuse with a coinsurance between 0% and 20%, Group Sessions for Outpatient Substance Abuse with a 20% coinsurance, and Outpatient Blood Services with a 20% coinsurance. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
The UHC Dual Complete GA-D001 (PPO D-SNP) plan covers ambulance services with a 20% coinsurance for both ground and air ambulance services, and covers transportation services with no copay. Transportation services to any health-related location are not covered, but the plan offers 36 one-way trips per year to plan-approved health-related locations via taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by UHC Dual Complete GA-D001 (PPO D-SNP). For Emergency Services, the copay is $110, and there is no coinsurance. Urgently Needed Services have a copay between $0 and $45, with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Physician Specialist Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Other Health Care Professional services have a coinsurance between 0% and 20%, while Chiropractic Services has a 20% coinsurance. Individual and Group Sessions for Mental Health and Psychiatric Specialty Services have a coinsurance between 0% and 20%. Podiatry Services have a 20% coinsurance, and a $0 copay. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay. Other preventive services include glaucoma screening, diabetes self-management training, and barium enemas with no copay, and digital rectal exams and EKG following Welcome Visit with 20% coinsurance.
Hearing Services See details
Hearing Services include coverage for routine hearing exams with no copay and at most 20% coinsurance, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered, with a maximum benefit of $1500 per year, and prescription hearing aids (all types) are covered with no copay. OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete GA-D001 (PPO D-SNP) plan covers eye exams and eyewear. Routine eye exams, eyeglass lenses, and eyeglass frames have no copay, while contact lenses also have no copay. Eyeglass frames have a combined maximum benefit of $150 every year, and eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete GA-D001 (PPO D-SNP) plan covers dental services including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Medicare Dental Services are covered with 20% coinsurance. Other services like orthodontics, restorative services, and more are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay, with a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete GA-D001 (PPO D-SNP) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Equipment which includes Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The UHC Dual Complete GA-D001 (PPO D-SNP) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a coinsurance of up to 20% and lab services with no copay. Diagnostic radiological services have a coinsurance of up to 20% with a minimum coinsurance of 0%, and therapeutic radiological services and outpatient X-ray services have a coinsurance of up to 20% with a minimum coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete GA-D001 (PPO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete GA-D001 (PPO D-SNP) plan. Although the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, none of these services are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the specific copay information is not provided. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefit with no copay, but 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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