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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 2025, 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 4 out of 5 stars in 2025.
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 $20.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.10. 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 FL-Y5 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your prescriptions in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, you will pay $20.30 for Part D. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a $1600 copay per admission, while outpatient services and primary care have a coinsurance between 0% and 20%. Emergency services have a $110 copay, and ambulance services have a 20% coinsurance. The plan also includes coverage for preventive, hearing, vision, and dental services, many with no copay. Additional benefits include no copay for transportation services to health-related locations, home health services, and OTC items. However, services like cardiac rehabilitation, skilled nursing facilities, and dialysis services may require prior authorization and have coinsurance or cost-sharing requirements.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered by the UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan. For Inpatient Hospital-Acute, you will pay a $1600 copay per admission or stay, with additional days 91-999 having no copay, while Non-Medicare-covered stays and Upgrades are not covered. Inpatient Hospital Psychiatric also has a $1600 copay per admission or stay, with Additional Days and Non-Medicare-covered stays not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a coinsurance of 0% to 20%, observation services have a 20% coinsurance, outpatient substance abuse individual sessions have a coinsurance of 0% to 20%, outpatient substance abuse group sessions have a 20% coinsurance, and outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, up to 72 one-way trips per year via taxi or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered under the UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45, while Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care Physician Services are covered with a coinsurance of 0% to 20%. Chiropractic Services, including routine care, are covered with no copay. Occupational Therapy Services are covered with a coinsurance of 0% to 20%, and Physician Specialist Services are covered with a coinsurance of 0% to 20%. Mental Health Specialty Services are covered with a coinsurance of 0% to 20% for individual sessions and 20% for group sessions. Podiatry Services, including routine foot care, are covered with a coinsurance of 20% and no copay. Other Health Care Professional services are covered with a coinsurance of 0% to 20%. Psychiatric Services are covered with a coinsurance of 0% to 20% for individual sessions and 20% for group sessions. Physical Therapy and Speech-Language Pathology Services are covered with a coinsurance of 0% to 20%. Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, as well as additional preventive services. Additional preventive services have a copay, and services such as Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay and include routine hearing exams, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered up to $3,200 per year and have no copay for all types. OTC hearing aids have no copay, with a limit of 2 per year.
Vision Services See details
The UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan covers vision services, including eye exams and eyewear, with no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, and eyeglass lenses and frames are not covered. The plan offers a combined maximum benefit of $500 per year for eyewear.
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), maxillofacial prosthetics, prosthodontics (fixed), and oral and maxillofacial surgery. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0% and 20%, while 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 FL-Y5 (HMO-POS D-SNP) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
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 are covered by the UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete FL-Y5 (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 by UHC Dual Complete FL-Y5 (HMO-POS D-SNP), but not in practice. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization and a doctor referral are required, and the plan charges the Medicare-defined cost share for tier 1.
Other Services See details
The UHC Dual Complete FL-Y5 (HMO-POS D-SNP) plan covers 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, and many additional services are not covered.
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