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UHC Dual Complete VA-Y001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete VA-Y001 (HMO-POS 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 VA-Y001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete VA-Y001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Virginia. The overall rating for this plan is not yet available for 2025.
It's important to know that UHC Dual Complete VA-Y001 (HMO-POS 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 VA-Y001 (HMO-POS 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 VA-Y001 (HMO-POS 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 VA-Y001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.10. 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 Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network 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:
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Drug Coverage
The UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan offers a wide range of benefits. Inpatient hospital stays have a $1,735 copay, while outpatient services, primary care, and many other services have coinsurance between 0% and 20%. Emergency and urgent care services have copays ranging from $0 to $110. Additional benefits include no copay for hearing aids, routine eye exams, and many dental services. The plan also covers ambulance and transportation services with 20% coinsurance, along with no copay for home health services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but require prior authorization. The copay for a Medicare-covered stay is $1,735, and additional days for Inpatient Hospital-Acute have no copay. 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 outpatient hospital services with a coinsurance of 0% to 20%, observation services with a 20% coinsurance, and ambulatory surgical center (ASC) services with a coinsurance between 0% and 20%. Outpatient substance abuse services are covered with a coinsurance between 0% and 20% for individual sessions, and a 20% coinsurance for group sessions. Outpatient blood services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan. 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 have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan covers Primary Care Physician Services with a coinsurance between 0% and 20%, Chiropractic Services with 20% coinsurance (but not routine care), Occupational Therapy Services with a coinsurance between 0% and 20%, Physician Specialist Services with a coinsurance between 0% and 20%, Mental Health Specialty Services with a coinsurance between 0% and 20% for individual sessions and 20% for group sessions, Podiatry Services with 20% coinsurance for routine foot care, Other Health Care Professional services with a coinsurance between 0% and 20%, Psychiatric Services with a coinsurance between 0% and 20% for individual sessions and 20% for group sessions, Physical Therapy and Speech-Language Pathology Services with a coinsurance between 0% and 20%, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services with varying copays. Some other preventive services are also covered, including glaucoma screening, diabetes self-management training, and barium enemas, all with no copay, while digital rectal exams and EKG following Welcome Visit have a 20% coinsurance. Health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, support for caregivers, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with 20% coinsurance and fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered, with a maximum benefit of $3200 per year and no copay, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan covers vision services, including routine eye exams with no copay. Eyewear benefits are covered with no copay, including contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $400 every year; however, eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services, and a maximum of $3,000 per year for Other Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventative dental services have no copay, but have limits on the number of visits. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Oral and Maxillofacial Surgery, and Maxillofacial Prosthetics are covered with no copay, but have limits on the number of visits; however, Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay with a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan and require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment is covered with coinsurance and copays, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of up to 20%, Therapeutic Radiological Services with a coinsurance of up to 20%, and Outpatient X-Ray Services with a coinsurance of up to 20%. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete VA-Y001 (HMO-POS 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 covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and the copay is based on the Medicare-defined cost share for tier 1.
Other Services See details
Under the UHC Dual Complete VA-Y001 (HMO-POS D-SNP) plan, 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. Over-the-Counter (OTC) Items have no copay, and Meal Benefits also have no copay and require prior authorization.
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