A non-government entity
UHC Dual Complete PA-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 PA-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 PA-V001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete PA-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 Pennsylvania. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete PA-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 PA-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 PA-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 PA-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $46.80. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. 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 $6700.00 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:
Sign up for UHC Dual Complete PA-V001 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs associated with your drugs. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS).
Additional Benefits
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan offers comprehensive coverage with a variety of benefits. This plan includes no copay for primary care visits, preventive services, eye exams, and many dental services. Hospital stays have a copay of $295 for days 1-6, and then no copay for the remainder of the stay. This plan also covers outpatient services, including mental health, with varying copays, and has no copay for ambulance transportation. Hearing aids and vision services are covered. This plan also includes coverage for services such as home health, skilled nursing facilities, and durable medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered. For days 1-6, there is a $295 copay, and for days 7-999, there is no copay. Additional days for inpatient hospital-acute have no copay. Non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered. Additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $295, Observation Services with a $295 copay, and Ambulatory Surgical Center (ASC) Services with no copay. Outpatient Substance Abuse services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under this plan, with a $55 copay. Prior authorization is required for coverage.
Ambulance and Transportation Services See details
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan covers ambulance services with a $290 copay for both ground and air ambulance services, with no coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, with a limit of 24 one-way trips per year, and transportation can be provided by taxi or medical transport. 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. For Emergency Services, you will pay a $125 copay and no coinsurance; for Urgently Needed Services, you will pay a copay between $0 and $50 with no coinsurance; and for Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan covers primary care physician services with no copay and chiropractic services with a $20 copay. Occupational therapy services have a copay between $0 and $25, while physician specialist services, physical therapy, speech-language pathology services, and additional telehealth benefits have a copay between $0 and $25. Mental health and psychiatric individual sessions have a copay between $0 and $25, and group sessions have a $15 copay. Podiatry services and other health care professional services have a copay between $25 and $25. Opioid treatment program services have 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 preventive services including Fitness Benefit and Home and Bathroom Safety Devices and Modifications with no copay. This plan does not cover 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, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), or Counseling Services.
Hearing Services See details
Hearing exams are covered with no copay. Prescription Hearing Aids (all types) are covered with a copay between $199 and $1249, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/Evaluation for Hearing Aids, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Vision services include coverage for eye exams with no copay, and eyewear benefits with no copay, including contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum plan benefit of $250 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Other services like Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery have no copay, and Orthodontic services have a maximum plan benefit coverage. Prosthodontics, removable, and Prosthodontics, fixed have a coinsurance between 0% and 50%. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Insulin has 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 PA-V001 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan covers Durable Medical Equipment (DME) with 20% coinsurance, and Prosthetic Devices with 20% coinsurance. Medical Supplies and Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance, and Diabetic Supplies have no copay. 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 with a copay for diagnostic procedures/tests, and a $0 copay for lab services. Radiological services include coverage for Diagnostic Radiological Services with a copay up to $200, Therapeutic Radiological Services with up to 20% coinsurance, and Outpatient X-Ray Services with a $25 copay.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP) 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 not covered under the UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan, but require prior authorization. You will have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits, both with no copay; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved