A non-government entity
UHC Dual Choice DC-Q001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Choice DC-Q001 (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-Q001 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Choice DC-Q001 (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 2025.
It's important to know that UHC Dual Choice DC-Q001 (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-Q001 (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-Q001 (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-Q001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $46.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.60. 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:
Sign up for UHC Dual Choice DC-Q001 (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 UHC Dual Choice DC-Q001 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your prescriptions based on the drug tier and pharmacy you use. The plan covers the costs of your prescriptions until your total drug costs reach $2,000. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $46.30.
Additional Benefits
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan offers a wide range of benefits with varying cost-sharing options. This plan includes inpatient hospital stays with a $1695 copay per admission, outpatient services with 0-20% coinsurance, and emergency services with a $110 copay. Many services have no copay, including preventive services, routine hearing exams, and vision services. This plan also provides coverage for ambulance services with 20% coinsurance, and offers no copay for transportation to health-related locations. Dental, hearing, and vision services are included, with some services having no copay and others with coinsurance or annual limits. Other key benefits include home health services with no copay, and coverage for home infusion and dialysis services, but cardiac rehabilitation services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization and have a copay of $1695 per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with 0% to 20% coinsurance, Observation Services with 20% coinsurance, Ambulatory Surgical Center (ASC) Services with 0% to 20% coinsurance, Outpatient Substance Abuse Services with 0% to 20% coinsurance for individual sessions and 20% coinsurance for group sessions, and Outpatient Blood Services with 20% coinsurance. This plan also waives the deductible for three pints of blood.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Choice DC-Q001 (PPO D-SNP) plan. This benefit has a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Choice DC-Q001 (PPO D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location are covered with no copay, up to 36 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay and no coinsurance, while 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
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, physician specialist services, and physical therapy services have a coinsurance between 0% and 20%, while chiropractic services and routine foot care have a coinsurance of 20%. Individual and group sessions for mental health specialty services have a coinsurance between 0% and 20%, and group sessions for psychiatric services have a coinsurance of 20%. Additional telehealth benefits and opioid treatment program services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while additional services like glaucoma screenings, diabetes self-management training, and barium enemas have no copay. Digital rectal exams and EKG following Welcome Visit have a 20% coinsurance. Certain services like health education, and counseling services are not covered.
Hearing Services See details
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan covers hearing exams with a coinsurance of at most 20% and routine hearing exams with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, up to a maximum of $1500 per year for both in-network and out-of-network services, while OTC hearing aids are covered with no copay for up to 2 hearing aids per year.
Vision Services See details
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan covers vision services including eye exams and eyewear. Eye exams and eyewear have no copay, and routine eye exams are limited to one per year. Contact lenses and eyeglass lenses are covered with no copay. Eyeglass frames are covered with no copay, limited to one per year, and the plan offers a combined maximum of $250.00 for all eyewear.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance, and other services with a $1,500 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, and prosthodontics (fixed) have no copay. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered, with prior authorization required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the UHC Dual Choice DC-Q001 (PPO D-SNP) plan. Durable Medical Equipment (DME) has a 19% coinsurance and requires prior authorization, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Choice DC-Q001 (PPO D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Choice DC-Q001 (PPO 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 not covered by the UHC Dual Choice DC-Q001 (PPO D-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered SNF stays, and it does not cover non-Medicare-covered SNF stays. The plan requires prior authorization and charges the Medicare-defined cost share for tier 1, but does not provide further details on cost sharing.
Other Services See details
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan's "Other Services" benefit includes over-the-counter (OTC) items and a meal benefit with no copay. Acupuncture and several 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