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UHC Dual Complete NE-S003 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NE-S003 (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 NE-S003 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete NE-S003 (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 Nebraska. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete NE-S003 (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 NE-S003 (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 NE-S003 (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 NE-S003 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $50.60. 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 $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 NE-S003 (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. If you qualify for the low-income subsidy (LIS), the monthly premium for Part D is $50.60. Once your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete NE-S003 (HMO-POS D-SNP) plan offers a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a high copay, while many outpatient services like primary care, vision, and dental exams have no copay. Other notable benefits include no copay for preventive services, hearing exams, and over-the-counter items. The plan also provides coverage for ambulance, emergency services, and home health services, but some services like skilled nursing and certain therapies have cost-sharing requirements.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including acute and psychiatric care, with a copay of $1920 per admission or stay for Medicare-covered stays. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a 0% to 20% coinsurance, observation services with a 20% coinsurance, and Ambulatory Surgical Center (ASC) services with a 0% to 20% coinsurance. Outpatient Substance Abuse Services are covered, with individual sessions having a 0% to 20% coinsurance and group sessions having a 20% coinsurance. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services with a 20% coinsurance, while Transportation Services to plan-approved health-related locations have no copay and are covered for 36 one-way trips per year. 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 Dual Complete NE-S003 (HMO-POS D-SNP) plan. Emergency Services has a $110 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete NE-S003 (HMO-POS D-SNP) plan covers primary care, chiropractic, occupational therapy, specialist, mental health, podiatry, and other health professional services. This plan has a coinsurance of 0%-20% for primary care physician, specialist, and physical therapy services; and 20% for chiropractic services. Individual and Group sessions for mental health services may have a coinsurance of 0%-20%. The plan also has a coinsurance of 20% for routine foot care, and a copay of $0 for routine foot care. Additional telehealth benefits are covered with no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, and additional services including Fitness Benefit and Home and Bathroom Safety Devices and Modifications. Other preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas with no copay, and Digital Rectal Exams and EKG following Welcome Visit with 20% coinsurance.
Hearing Services See details
Hearing services include routine hearing exams with no copay and a coinsurance of at most 20%, and prescription hearing aids with no copay. OTC hearing aids are covered with no copay.
Vision Services See details
Under the UHC Dual Complete NE-S003 (HMO-POS D-SNP) plan, vision services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay, and routine eye exams are limited to one per year. Contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, and eyeglass lenses and eyeglass frames are limited to one per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, and other dental services with a maximum plan benefit of $3,000 every year. 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), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics, Medical Supplies, and Diabetic Equipment, is covered. DME and Prosthetic Devices have a 20% coinsurance, while Medical Supplies also have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete NE-S003 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests have a coinsurance of at most 20%, and Lab Services have no copay. Diagnostic Radiological Services have a coinsurance of at most 20% with a minimum coinsurance of 0%, Therapeutic Radiological Services have a coinsurance of at most 20% with a minimum coinsurance of 20%, and Outpatient X-Ray Services have a coinsurance of at most 20% with a minimum coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NE-S003 (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered by the plan.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but all the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. Prior authorization is required for this benefit.
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 stays or non-Medicare-covered SNF stays. You will be responsible for the Medicare-defined cost share for tier 1, and a copay applies, but the specific amount is not detailed.
Other Services See details
Other Services include over-the-counter items and meal benefits. Over-the-counter items have no copay, and meal benefits also have no copay, but require 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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