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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 2026, 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 2026.
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 $30.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. 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 $615.00 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:
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Drug Coverage
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for 1-month and 3-month supplies at standard pharmacies and through standard mail order. This makes managing basic prescriptions highly cost-effective for members. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to 1-month and 3-month supplies for Tier 2 and Tier 3 drugs at standard pharmacies and standard mail order. For Tier 4 and Tier 5 drugs, the 25% coinsurance applies to 1-month supplies filled at standard pharmacies or through standard mail order.
Additional Benefits
The UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan offers comprehensive healthcare coverage with no coinsurance for many key services, including inpatient hospital stays, primary care, and preventive care. You will pay no copay for primary care visits, preventive services, and home health care, while specialist visits carry a copay ranging from $0 to $35. For emergency care, there is a $130 copay that is waived if you are admitted, alongside a $290 copay for ambulance services. This plan also features essential routine benefits, including dental preventive care and routine vision exams with no copay, plus a $200 annual allowance for eyewear. Routine hearing exams also feature no copay, though prescription hearing aids require a copayment. Additionally, diagnostic lab services and diabetic supplies are covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) offers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $350 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services carry no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP), featuring a $290 copay and no coinsurance for both ground and air ambulance services. Transportation benefits are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers primary care and telehealth services with no copay and no coinsurance, while chiropractic services are not covered. Specialist visits require a $0 to $35 copay, and physical, occupational, and speech therapies require a $30 copay, all with no coinsurance.
Preventive Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive benefits are partially covered, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing Services are partially covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP), offering one annual routine hearing exam with no copay and no coinsurance. Up to two prescription hearing aids (with copays ranging from $199.00 to $1,249.00) and two OTC hearing aids (with copays ranging from $199.00 to $829.00) are covered annually with no coinsurance, but fitting or evaluation exams as well as inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP) with no copay and no coinsurance for covered benefits, which include one routine eye exam per year and a $200 annual limit for contact lenses, eyeglass lenses, and eyeglass frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered, and prior authorization is required for exams.
Dental Services See details
Dental services are partially covered by UHC Dual Complete PA-V001 (HMO-POS D-SNP), featuring Medicare-covered dental services with no copay and a 20% coinsurance. Preventive care including exams, cleanings, x-rays, and fluoride is available with no copay and no coinsurance, but restorative, endodontic, periodontic, prosthodontic, orthodontic, implant, and oral surgery services are not covered.
Home Infusion bundled Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and radiation, carry a coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs require a $35.00 copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis services are covered under UHC Dual Complete PA-V001 (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic therapeutic shoes or inserts, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay and no coinsurance, with prior authorization required for most equipment and supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Dual Complete PA-V001 (HMO-POS D-SNP) plan, with prior authorization required for all services. There is no copay or coinsurance for lab services and diagnostic radiology, but diagnostic procedures and tests require a $35 copay, outpatient X-rays require a $25 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under UHC Dual Complete PA-V001 (HMO-POS D-SNP) with no copay and no coinsurance, subject to prior authorization. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required and a prior three-day hospital stay is not needed, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete PA-V001 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
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