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UHC Dual Complete DE-S001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete DE-S001 (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 DE-S001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete DE-S001 (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 State of Delaware. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete DE-S001 (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 DE-S001 (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 DE-S001 (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 DE-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $46.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.80. 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 DE-S001 (HMO-POS 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 (LIS), the monthly premium for Part D is $46.30. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs, though you may still pay for excluded drugs covered under any enhanced benefit.
Additional Benefits
The UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan offers a wide array of benefits with varying cost structures. Inpatient hospital stays have a $1725 copay per admission, while outpatient services and primary care visits typically involve coinsurance between 0% and 20%. Emergency services have a $110 copay, and transportation services to health-related locations are available with no copay for up to 36 one-way trips. The plan includes no copays for preventive services, eye exams, and many dental services like cleanings and X-rays. It also covers hearing exams with coinsurance, and provides no copay for prescription and OTC hearing aids. Additionally, it offers no copay for home health services, and medical equipment with a 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For Inpatient Hospital-Acute, there is a copay of $1725 per admission or stay, with additional days covered with no copay. Inpatient Hospital Psychiatric services have a copay of $1725 per admission or stay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a 0% to 20% coinsurance, observation services with a 20% coinsurance, and ambulatory surgical center services with a 0% to 20% coinsurance. Outpatient substance abuse services are covered with 0% to 20% coinsurance for individual sessions and 20% coinsurance for group sessions, and outpatient blood services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay, with up to 36 one-way trips per year via taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Dual Complete DE-S001 (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 have no copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered, with coinsurance between 0% and 20% for some services and no copay for Additional Telehealth Benefits and Opioid Treatment Program Services. Chiropractic Services are partially covered, with a 20% coinsurance for routine care, but routine chiropractic care is not covered. Podiatry Services are covered with a 20% coinsurance for routine foot care, and Medicare-covered podiatry services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams with no copay, and additional preventive services with no copay for fitness and home and bathroom safety devices. Some services are not covered, including Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS).
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 are not covered. Prescription hearing aids are covered, and OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay. Eyewear benefits include contact lenses, eyeglass lenses, and eyeglass frames with no copay, but eyeglass frames and lenses are limited to one per year, while contact lenses are unlimited. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan covers dental services, including Medicare Dental Services with 20% coinsurance, and other dental services with a $2,500 annual maximum. Oral exams, dental X-rays, other diagnostic and preventive services, and cleanings have no copay, and other preventive services are covered with a $0 copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. 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, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. The plan has a $35 copay and 0-20% coinsurance for Medicare Part B Insulin Drugs, and 0-20% coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment is covered, with a 20% coinsurance for Durable Medical Equipment and Prosthetic Devices, and no copay. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Diagnostic Radiological Services have a coinsurance of at most 20% with a minimum coinsurance of 0%. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the UHC Dual Complete DE-S001 (HMO-POS D-SNP) plan, but the specific copay is not detailed in the provided information. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) items and Meal Benefits, with no copay for either. 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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