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UHC Dual Complete PA-S3 (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-S3 (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-S3 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete PA-S3 (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 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-S3 (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-S3 (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-S3 (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-S3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $9250.00 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-S3 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for one-month and three-month supplies at standard pharmacies and through standard mail order. This ensures that essential everyday medications remain highly accessible and budget-friendly for members. For higher-tier medications, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, members typically pay a 25% coinsurance. This 25% coinsurance rate applies to standard retail pharmacy purchases as well as standard mail-order deliveries. Understanding these cost-sharing details helps you estimate your out-of-pocket prescription expenses under the UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan.
Additional Benefits
The UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan offers comprehensive medical coverage with no copays for primary care, specialist visits, and outpatient hospital services, though some care may require up to 20% coinsurance. Inpatient hospital admissions carry a $1,600 copay with no coinsurance, while emergency care has a $115 copay that is waived upon admission. Essential benefits like home health care and skilled nursing facility stays are fully covered with no copays and no coinsurance. Supplemental benefits include routine dental and vision care with no copays or coinsurance, featuring a $2,500 annual dental limit and a $200 yearly eyewear allowance. Members also benefit from up to 36 one-way transportation trips per year, over-the-counter items, and routine hearing aids with no copays or coinsurance. Durable medical equipment, dialysis, and various diagnostic services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,600 copay per admission and no coinsurance, subject to prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers outpatient services with no copays, though prior authorization is required and coinsurance ranges from no coinsurance to 20%. Specifically, outpatient hospital, ambulatory surgical center, and substance abuse services feature 0% to 20% coinsurance, while outpatient blood and observation services carry a 20% coinsurance.
Partial Hospitalization See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay and no coinsurance, but trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from no copay to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) offers primary care, specialist, and mental health services with no copay and 0% to 20% coinsurance, while telehealth and opioid treatments have no copay and no coinsurance. Physical, occupational, speech, and routine podiatry services carry a 20% coinsurance and no copay, though chiropractic benefits are only partially covered since routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP), featuring no copay and no coinsurance for annual physical exams, kidney disease education, fitness programs, and in-home support. While supplemental services such as health education, telemonitoring, and alternative therapies are not covered, certain diagnostics like digital rectal exams and EKGs require a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP), featuring one annual routine hearing exam with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (excluding inner ear, outer ear, and over the ear types) and up to two OTC hearing aids are covered every two years with no copay or coinsurance, with prescription aids limited to a $2,200 maximum.
Vision Services See details
Vision services are partially covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP) with no copay and no coinsurance, including one annual routine eye exam and up to $200 yearly for contact lenses, eyeglass lenses, and eyeglass frames. Other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP), as implant services and orthodontics are not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,500 annual maximum.
Home Infusion bundled Services See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy and other drugs require no coinsurance to 20% coinsurance, while insulin drugs carry a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP) with prior authorization, featuring no copay or coinsurance for diagnostic radiological services and no copay for lab services. Medicare-covered diagnostic procedures require both a copay and 20% coinsurance, while therapeutic radiology and outpatient X-ray services require 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered under the UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Dual Complete PA-S3 (HMO-POS D-SNP) with no copay, a 20% coinsurance, and prior authorization requirements. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete PA-S3 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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