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UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) in 2025, please refer to our full plan details page.
UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Colorado. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Rocky Mountain Dual Complete CO-S003 (HMO 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 Rocky Mountain Dual Complete CO-S003 (HMO 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 Rocky Mountain Dual Complete CO-S003 (HMO 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 Rocky Mountain Dual Complete CO-S003 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, you will pay $37.00. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan offers a wide array of benefits, including coverage for inpatient and outpatient services, with varying cost-sharing. Many services, such as primary care visits, preventive services, and some vision and hearing services, have no copay. The plan also covers home health services with no copay or coinsurance, and offers benefits like OTC items and meal benefits. This plan includes coverage for emergency services, with a copay for emergency room visits and urgent care. It also covers a variety of other services, like home infusion, dialysis, and medical equipment, with varying copays and coinsurance amounts. Dental services are partially covered, and skilled nursing facilities are covered with the Medicare-defined cost share for tier 1, and some other services require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, there is a $2,000 copay per admission or stay, and additional days have no copay; Non-Medicare-covered stays and upgrades are not covered. For Inpatient Hospital Psychiatric, additional days and non-Medicare-covered stays are not covered, and there is a $2,000 copay per admission or stay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a 0% - 20% coinsurance, observation services with a 20% coinsurance, and ambulatory surgical center services with a 0% - 20% coinsurance. Outpatient substance abuse services are covered, including individual sessions with a 0% - 20% coinsurance and group sessions with a 20% coinsurance. Outpatient blood services are covered with 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 by the UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and there is 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 Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan covers Primary Care Physician Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services with a coinsurance of 0% to 20%, and also covers Occupational Therapy Services with a coinsurance of 0% to 20%. Chiropractic Services are covered with 20% coinsurance, while routine chiropractic care is not covered. This plan also provides Additional Telehealth Benefits with no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and other preventive services, with some services requiring a copay or coinsurance. Glaucoma screenings, Diabetes Self-Management Training, and Barium Enemas have no copay, while Digital Rectal Exams and EKG following Welcome Visit have 20% coinsurance. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, and OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Contact lenses, eyeglass lenses, and eyeglass frames are covered, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan. Medicare Dental Services are covered with a 20% coinsurance, while Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and 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 Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan, but require prior authorization. You will pay a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Rocky Mountain Dual Complete CO-S003 (HMO D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay, and Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Rocky Mountain Dual Complete CO-S003 (HMO 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 specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required, and coinsurance applies.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered SNF or non-Medicare-covered stays. Prior authorization is required, and you will have to pay the Medicare-defined cost share for tier 1.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefits. Over-the-Counter (OTC) Items have no copay, and Meal Benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other sub-services are not covered.
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