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UHC Dual Complete DE-V001 (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-V001 (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-V001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete DE-V001 (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-V001 (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-V001 (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-V001 (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-V001 (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 $6500.00 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-V001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs as outlined in the plan's formulary. If you qualify for the low-income subsidy (LIS), you will pay $46.30 per month for your Part D premium. Once your total drug costs reach $2000, you will enter the next coverage phase.
Additional Benefits
The UHC Dual Complete DE-V001 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. You'll have no copay for primary care visits, preventive services, and many outpatient services, including vision and dental exams. However, you'll pay copays for inpatient hospital stays, emergency services, and some specialist visits. This plan also provides coverage for hearing aids, home health services, and medical equipment, with some services requiring coinsurance. Additionally, it offers a meal benefit and coverage for over-the-counter items. Remember that some services require prior authorization, and there are limits on certain benefits.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including acute and psychiatric, with a copay of $325 for days 1-6 and no copay for days 7-90. Additional days for inpatient acute hospital stays have no copay, while non-Medicare-covered stays and upgrades for inpatient acute hospital and additional days and non-Medicare-covered stays for inpatient psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $325, Observation Services with a $325 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial hospitalization is covered by this plan, with a copay of $55. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $290 copay. Transportation Services to plan-approved health-related locations are covered with no copay, with a limit of 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete DE-V001 (HMO-POS D-SNP) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, but routine care is not covered. Occupational therapy services have a copay between $0 and $30, and physician specialist services have a copay between $0 and $25. Mental health specialty services have a copay of $0-$25 for individual sessions and $15 for group sessions. Podiatry services, including routine foot care, have a $25 copay. Other health care professional services have a copay between $0 and $25. Psychiatric services have a copay of $0-$25 for individual sessions and $15 for group sessions. Physical therapy and speech-language pathology services have a copay between $0 and $30. Additional telehealth benefits have no copay, and opioid treatment program services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services and annual physical exams with no copay. Other preventive services include Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, including routine hearing exams. Prescription hearing aids are covered with a copay between $199 and $1249, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, as well as prescription hearing aids - inner ear, outer ear, and over the ear, are not covered.
Vision Services See details
Vision services include eye exams and eyewear, with no copay for covered services. Routine eye exams and contact lenses are covered with no copay, while eyeglass lenses and frames are covered with no copay and are limited to one per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete DE-V001 (HMO-POS D-SNP) plan covers Medicare dental services with a 20% coinsurance, and covers other dental services up to a maximum of $750 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. Prosthodontics (removable and fixed) have a coinsurance of 0-50%. Orthodontic and implant services 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%.
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 is covered, including Durable Medical Equipment with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Equipment is covered, including Diabetic Supplies with no copay and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay of $50, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a copay of at most $225, therapeutic radiological services with at least 20% coinsurance, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete DE-V001 (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, 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 for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and a Meal Benefit with no copay, though 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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