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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 2025, 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 4 out of 5 stars in 2025.
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 $20.30. 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 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 FL-Y001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $20.30 per month for Part D. During the initial coverage phase, after you meet your deductible, you will pay the costs for your drugs. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete FL-Y001 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing. Many services, like inpatient hospital stays, outpatient services, primary care, preventive services, vision, and dental, have no copay. Other services, such as emergency services, partial hospitalization, and home infusion, have copays or coinsurance. The plan also provides coverage for hearing aids, medical equipment, and home health services. Additionally, this plan covers ambulance and transportation services, with no copay for ambulance services and transportation to plan-approved health-related locations. However, services like cardiac rehabilitation, and some other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital-Acute, there is no copay for a Medicare-covered stay, and additional days (91-999) have no copay, and for Inpatient Hospital Psychiatric, there is no copay for a Medicare-covered stay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a coinsurance of 0-20% for individual sessions and 20% for group sessions. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with no coinsurance. Ground and Air Ambulance Services have no copay. Transportation Services to a plan-approved health-related location are covered for up to 72 one-way trips per year with no copay; transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45; all have no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care, Chiropractic, Occupational Therapy, Physician Specialist, Mental Health Specialty, Podiatry, Other Health Care Professional, Psychiatric, Physical Therapy and Speech-Language Pathology, Additional Telehealth, and Opioid Treatment Program Services are covered. Chiropractic, Podiatry, and Additional Telehealth Services require prior authorization. For Primary Care Physician, Chiropractic, Physician Specialist, and Telehealth Services, there is no copay. For Mental Health Specialty Services, the coinsurance is between 0% and 20% depending on the service. For Podiatry Services, the coinsurance is 20% for Routine Foot Care, and the copay is $0 for Medicare-covered Podiatry Services. For Other Health Care Professional and Opioid Treatment Program Services, there is no copay. For Physical Therapy and Speech-Language Pathology Services, there is no copay or coinsurance.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Other preventive services include Fitness Benefit, Home and Bathroom Safety Devices and Modifications with no copay, and the following services with a 20% coinsurance: Digital Rectal Exams and EKG following Welcome Visit.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and over-the-counter (OTC) hearing aids. Hearing exams have no copay for routine exams, which are limited to one per year, while fitting/evaluation for hearing aids are not covered. Prescription hearing aids have a maximum benefit of $3200 per year, with no copay for all types of prescription hearing aids, limited to two per year, with inner ear, outer ear, and over the ear prescription hearing aids not covered. OTC hearing aids have no copay, with a limit of two hearing aids per year.
Vision Services See details
Vision services include routine eye exams and eyewear. Routine eye exams and eyewear have no copay. Eyeglass lenses and frames are not covered.
Dental Services See details
Dental Services are covered, with no copay for Medicare Dental Services, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Oral and Maxillofacial Surgery. Maxillofacial Prosthetics are covered, however, Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered with prior authorization and a doctor referral, and the coinsurance is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered under this plan. There is no copay for diagnostic procedures/tests, lab services, diagnostic radiological services, and outpatient X-ray services, and the copay for therapeutic radiological services is at most $0.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete FL-Y001 (HMO-POS D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization and a referral are required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete FL-Y001 (HMO-POS D-SNP) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, requiring prior authorization and a doctor's referral. This plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits. The plan offers Over-the-Counter (OTC) Items with no copay, and Meal Benefits with no copay, but requires prior authorization. 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.
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