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UHC Dual Complete FL-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 FL-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 FL-Y001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete FL-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 Florida. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete FL-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 FL-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 FL-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 FL-Y001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $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 Maximum Out-Of-Pocket cost of $9250.00 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 FL-Y001 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are covered with no copay for a 1-month or 3-month supply at standard pharmacies, as well as no copay for a 3-month supply via standard mail order. For Tier 2 generic drugs, members are responsible for a 25% coinsurance for standard pharmacy fills and standard mail orders. Tier 3 preferred brand drugs also carry a 25% coinsurance for standard pharmacy and standard mail order options. Similarly, Tier 4 non-preferred drugs and Tier 5 specialty tier drugs require a 25% coinsurance for a 1-month supply at standard pharmacies and through standard mail order. This clear cost-sharing structure helps you easily project your out-of-pocket prescription medication expenses.
Additional Benefits
The UHC Dual Complete FL-Y001 (HMO-POS D-SNP) offers comprehensive medical coverage with no copays and no coinsurance for inpatient hospital stays, outpatient services, primary care, and specialist visits. Emergency room visits require a $115 copay, which is waived if you are admitted within 24 hours, while urgent care services feature no copay up to a $40 copay. Additionally, diagnostic services, home health care, and skilled nursing facility stays are covered with no copays or coinsurance. Supplemental benefits include dental coverage with no copay or coinsurance up to a $4,000 annual limit, alongside vision and hearing benefits that offer no copays, no coinsurance, and allowance credits for eyewear and hearing aids. Routine transportation is also covered with no copay for up to 72 one-way trips per year to plan-approved locations. While diabetic supplies feature no copay or coinsurance, durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) partially covers inpatient hospital services, offering Medicare-covered acute and psychiatric stays with no copay and no coinsurance. While unlimited additional acute days are covered, upgrades and non-Medicare-covered stays are not covered, and prior authorization is required.
Outpatient Services See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers outpatient hospital, observation, and ambulatory surgical center services with no copay and no coinsurance. Outpatient substance abuse services feature no copay and coinsurance ranging from no coinsurance to 20%, while outpatient blood services require no copay and 20% coinsurance with no deductible.
Partial Hospitalization See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay and no coinsurance. Ambulance services require prior authorization, while transportation services are partially covered, providing up to 72 one-way trips per year to plan-approved locations while excluding trips to any health-related location.
Emergency Services See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers emergency services with a $115 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers primary care, specialist, telehealth, and therapy services with no copay and no coinsurance. Mental health and psychiatric services feature no copay but require up to 20% coinsurance, routine podiatry carries a 20% coinsurance, and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP), featuring no copay and no coinsurance for annual physicals, kidney disease education, and fitness benefits, while digital rectal exams and EKGs require a 20% coinsurance. Several supplemental options are not covered, including health education, personal emergency response systems, nutritional/dietary benefits, and alternative therapies.
Hearing Services See details
Hearing services are partially covered under the UHC Dual Complete FL-Y001 (HMO-POS D-SNP) plan with no copay and no coinsurance, which includes one routine hearing exam annually and up to two prescription or over-the-counter hearing aids every two years with a $3,200 maximum allowance. Fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay or coinsurance, offering one routine eye exam annually and a $400 yearly allowance for eyeglasses, contact lenses, and upgrades. This benefit is partially covered, as other eye exam services, separate eyeglass lenses, and separate frames are not covered.
Dental Services See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) offers partially covered dental services with a $4,000 annual maximum, excluding implant services and orthodontics which are not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive services are available with no copay and no coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay, though prior authorization is required. Covered 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 under the UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment and supplies are covered with no copay and no coinsurance, though prior authorization is required for all medical equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required. Covered services include lab tests, diagnostic procedures, outpatient X-rays, and therapeutic radiological services.
Home Health Services See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, although prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Under UHC Dual Complete FL-Y001 (HMO-POS D-SNP), some cardiac rehabilitation services are covered with no copay, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance. Prior authorization and a referral are required for these rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete FL-Y001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization and referrals are required. This benefit does not require a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) covers select other services with no copay and no coinsurance, including over-the-counter (OTC) items and chronic illness meal benefits, though prior authorization is required for meals. Acupuncture and other miscellaneous services under this category are not covered.
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