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UHC Dual Complete FL-Y5 (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-Y5 (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-Y5 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete FL-Y5 (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-Y5 (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-Y5 (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-Y5 (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-Y5 (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 $0.60. 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 $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-Y5 (HMO-POS D-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies, or for a 3-month supply through standard mail order. This plan provides an affordable way to manage your essential everyday medications. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a consistent 25% coinsurance. This 25% coinsurance applies to standard pharmacy and standard mail order options for covered prescriptions. Knowing these straightforward cost-sharing rates helps you plan your healthcare budget effectively.
Additional Benefits
The UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring no copays for primary care visits, specialist consultations, and outpatient services, with coinsurance ranging from 0% to 20%. Inpatient hospital admissions require an $1,805 copay with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. Additionally, emergency ambulance rides require a 20% coinsurance, and the plan provides up to 72 free one-way trips per year to plan-approved locations. Ancillary benefits are highly accessible, offering no copays or coinsurance for routine vision exams with a $400 eyewear allowance, up to $4,000 in preventive and comprehensive dental care, and a $2,500 hearing aid allowance every two years. Members also benefit from no copay and no coinsurance for home health services, skilled nursing facility care, and over-the-counter items. For durable medical equipment and dialysis services, the plan charges no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,805 copay per admission and no coinsurance. Unlimited additional acute hospital days are covered with no copay, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) covers outpatient services with no copays, with coinsurance ranging from 0% to 20% depending on the specific service. Covered benefits include outpatient hospital care, ambulatory surgical center services, substance abuse treatment, and outpatient blood services, with most requiring prior authorization and referrals.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 72 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary Care services for UHC Dual Complete FL-Y5 (HMO-POS D-SNP) are covered with no copay and coinsurance ranging from 0% to 20% for primary care, specialist, and mental health visits. Chiropractic care is partially covered, providing 12 routine visits per year with no copay or coinsurance, though other chiropractic services are not covered. Therapy services require a 20% coinsurance and no copay, while telehealth and opioid treatment are available with no copay and no coinsurance.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP), featuring no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, diabetes training, fitness benefits, caregiver support, and home safety devices. While digital rectal exams and post-welcome visit EKGs require a 20% coinsurance, several sub-services are not covered, including health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) partially covers hearing services with no copay and no coinsurance for routine hearing exams and OTC or prescription hearing aids, featuring a $2,500 maximum coverage limit every two years. Fitting and evaluation for hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) offers vision services with no copay, no coinsurance, and no deductible, which includes one routine eye exam per year and a $400 annual allowance for contact lenses, upgrades, and eyeglasses (lenses and frames). This benefit is partially covered because other eye exam services, eyeglass lenses, and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP), with Medicare-covered dental services requiring no copay and a 20% coinsurance. Other covered preventive and comprehensive dental services feature no copay and no coinsurance up to a $4,000 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 Complete FL-Y5 (HMO-POS D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, have no coinsurance to 20% coinsurance, with insulin drugs also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic equipment and supplies are also covered with no copay and no coinsurance, though brand limitations and prior authorization requirements apply to these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP) with prior authorization required. Diagnostic procedures require a copay and a minimum 20% coinsurance, lab services have no copay, and radiological services feature no copays with coinsurance ranging from no coinsurance for diagnostic radiology to a minimum of 20% for therapeutic and X-ray services.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP) with no copay and no coinsurance. Both prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) offers cardiac rehabilitation services with no copay, though specific sub-services—including intensive cardiac, pulmonary, and supervised exercise therapy for peripheral artery disease—are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete FL-Y5 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization and a referral are required. While the plan allows for admission without a prior three-day inpatient hospital stay, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete FL-Y5 (HMO-POS 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 under this category are not covered.
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