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UHC Dual Choice DC-Y2 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Choice DC-Y2 (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 Choice DC-Y2 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Choice DC-Y2 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Washington, DC. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Choice DC-Y2 (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 Choice DC-Y2 (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 Choice DC-Y2 (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 Choice DC-Y2 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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:
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Drug Coverage
The UHC Dual Choice DC-Y2 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Members enjoy no copay for Tier 1 preferred generic drugs for both one-month and three-month supplies at standard pharmacies, as well as three-month supplies filled through standard mail order. This makes starting and maintaining common medications highly affordable. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance for filled prescriptions. This 25% coinsurance applies to standard pharmacy and standard mail order options for both one-month and three-month supplies, depending on the specific tier. Understanding these tier structures helps you accurately budget for your monthly and yearly healthcare costs.
Additional Benefits
The UHC Dual Choice DC-Y2 (PPO D-SNP) plan offers comprehensive coverage for core medical services, featuring no copays for primary care, specialist visits, outpatient services, and home health care, though coinsurance up to 20% may apply to some treatments. Inpatient hospital stays require a copay of $2,230 per admission for acute stays and $2,080 for psychiatric stays, with no coinsurance. Emergency care is covered with a $115 copay that is waived upon admission, while urgent care and worldwide emergency services have low to no copays. For additional care, this plan provides annual physicals, skilled nursing facility stays, and over-the-counter items with no copay and no coinsurance. Medicare-covered dental, dialysis, and durable medical equipment are covered with no copay and a 20% coinsurance. However, routine vision care, routine dental services, and hearing aids are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are covered by UHC Dual Choice DC-Y2 (PPO D-SNP) with no coinsurance, requiring a $2,230 copay per admission for acute stays and a $2,080 copay per admission for psychiatric stays. While unlimited additional acute days are covered with no copay, non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under UHC Dual Choice DC-Y2 (PPO D-SNP) are covered with no copay, with coinsurance ranging from no coinsurance up to 20% depending on the specific service. This includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, though prior authorization is required.
Partial Hospitalization See details
UHC Dual Choice DC-Y2 (PPO 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
Ambulance services under UHC Dual Choice DC-Y2 (PPO D-SNP) are covered with a 20% coinsurance and no copay for both ground and air transport, though prior authorization is required. Routine transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
UHC Dual Choice DC-Y2 (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 require 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
UHC Dual Choice DC-Y2 (PPO D-SNP) covers primary care, specialist, mental health, and therapy services with no copay and 0% to 20% coinsurance, while telehealth and opioid treatments have no copay and no coinsurance. For chiropractic benefits, some services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physicals, kidney disease education, fitness programs, weight management, and in-home support, while digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance and no copay. Non-covered services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, additional smoking cessation, disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Choice DC-Y2 (PPO D-SNP), which offers one routine hearing exam per year with no copay, a 20% coinsurance, and no deductible. Prior authorization is required for exams, and hearing aid fittings, prescription hearing aids, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Vision services are technically covered under the UHC Dual Choice DC-Y2 (PPO D-SNP) plan with no copay and no coinsurance, but in practice, the benefit is not covered because routine eye exams, other eye exams, contact lenses, and eyeglasses are all not covered.
Dental Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) partially covers dental services, offering Medicare-covered dental benefits with no copay and a 20% coinsurance, though prior authorization is required. Routine and comprehensive dental services, such as cleanings, exams, x-rays, restorative treatments, endodontics, periodontics, and orthodontics, are not covered.
Home Infusion bundled Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Choice DC-Y2 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Choice DC-Y2 (PPO D-SNP) with no copay, though a 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for most of these medical equipment benefits.
Diagnostic and Radiological Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) covers diagnostic and radiological services with prior authorization required, offering lab services with no copay and diagnostic procedures with a copay and 20% coinsurance. Radiological services have no copays, featuring no coinsurance for diagnostic radiology and a 20% coinsurance for therapeutic radiology and outpatient X-rays.
Home Health Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) covers cardiac rehabilitation services with no copay and prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Choice DC-Y2 (PPO D-SNP) partially covers skilled nursing facility (SNF) services with no copay and no coinsurance, though prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Choice DC-Y2 (PPO D-SNP) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture, highly integrated dual eligible services, and other miscellaneous services are not covered.
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