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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 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Choice DC-Q001 (PPO D-SNP) is a PPO D-SNP plan offered by Care Improvement Plus South Central Insurance Co. available for the 2026 plan year 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-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 $22.50. 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
Health deductible: same as Medicare's Part B deductible.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $13900.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of 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:
Sign up for UHC Dual Choice DC-Q001 (PPO D-SNP)
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Drug Coverage
The UHC Dual Choice DC-Q001 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs for both 1-month and 3-month supplies at standard pharmacies and through standard mail order. For Tier 2 generic and Tier 3 preferred brand drugs, there is a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs also require a 25% coinsurance for 1-month supplies at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Choice DC-Q001 (PPO D-SNP) plan offers comprehensive healthcare coverage with many essential services featuring no copayments. Members benefit from no copays on primary care, specialist visits, outpatient services, and home health care, with coinsurance typically ranging from 0% to 20%. While inpatient hospital stays require copays of $2,160 for acute care and $2,080 for psychiatric care, preventive care and skilled nursing facility stays feature no copays. The plan also includes valuable supplemental benefits like routine dental, vision, and hearing care, which offer no copays alongside annual allowances for glasses, hearing aids, and dental services. Additionally, members receive up to 24 free one-way transportation trips per year and covered over-the-counter items with no copay. Emergency services are covered with a $115 copay that is waived if admitted, while durable medical equipment and dialysis require no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Choice DC-Q001 (PPO D-SNP) with no coinsurance, requiring a $2,160 copay per acute stay and a $2,080 copay per psychiatric stay, both of which require prior authorization. While unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Choice DC-Q001 (PPO D-SNP) with no copays and coinsurance ranging from no coinsurance to 20%. Covered services include outpatient hospital care, ambulatory surgical centers, substance abuse therapy, and blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Dual Choice DC-Q001 (PPO D-SNP) plan with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Choice DC-Q001 (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 or coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Choice DC-Q001 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, though the copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $0 to $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are available with no copay and no coinsurance.
Primary Care See details
UHC Dual Choice DC-Q001 (PPO D-SNP) covers primary care, specialist, and therapy services with no copays and coinsurance ranging from 0% to 20%. Telehealth and opioid treatment are available with no copays and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
UHC Dual Choice DC-Q001 (PPO D-SNP) features partially covered preventive services with no copay and no coinsurance for annual physicals, kidney disease education, fitness programs, and in-home support. A 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs, while services such as health education, PERS, medical nutrition therapy, alternative therapies, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Choice DC-Q001 (PPO D-SNP), offering one annual routine exam with no copay and 20% coinsurance, while fitting/evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered. Covered prescription hearing aids (up to a $1,500 limit every two years) and OTC hearing aids both feature no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Dual Choice DC-Q001 (PPO D-SNP) with no copay and no coinsurance for covered benefits. Members receive one routine eye exam per year (prior authorization required) and a $200 annual maximum for contact lenses, eyeglass lenses, and eyeglass frames, while other eye exams, combined eyeglasses, and upgrades are not covered.
Dental Services See details
Dental services under UHC Dual Choice DC-Q001 (PPO D-SNP) are partially covered, with Medicare-covered dental services requiring no copay and a 20% coinsurance. Other preventive and comprehensive dental services are available with no copay and no coinsurance up to a $1,000 annual maximum, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Choice DC-Q001 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
UHC Dual Choice DC-Q001 (PPO D-SNP) covers Dialysis Services 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-Q001 (PPO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
UHC Dual Choice DC-Q001 (PPO D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures and tests require a copay and a minimum 20% coinsurance, while lab services require coinsurance with no copay. Diagnostic radiological services are covered with no copay and no coinsurance, whereas therapeutic radiology and outpatient X-rays require a minimum 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by UHC Dual Choice DC-Q001 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under UHC Dual Choice DC-Q001 (PPO D-SNP) require prior authorization and feature no copay, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Choice DC-Q001 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. The plan allows SNF admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Choice DC-Q001 (PPO D-SNP), offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though meals require prior authorization. Acupuncture and other additional services are not covered under this benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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