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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 2025, 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 2025.
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 $48.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.20. 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 PA-S3 (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, but the specific costs for each tier are not provided in this summary. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $48.40.
Additional Benefits
The UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays and coinsurance. Emergency, urgent, and worldwide emergency services are covered, with some services having no copay. The plan also includes coverage for primary care, preventive, hearing, vision, and dental services, with specific copays and coinsurance amounts. Additional benefits include coverage for ambulance and transportation services, home infusion, dialysis, medical equipment, and diagnostic services. The plan also offers home health services with no copay, and covers other services like over-the-counter items and meal benefits. However, certain services like skilled nursing, acupuncture, and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered, with a copay of $1345 per admission or stay; however, the plan does not cover Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute has no copay.
Outpatient Services See details
Outpatient Services include all outpatient hospital services, observation services, and outpatient substance abuse services, with coinsurance ranging from 0% to 20%. Outpatient blood services have a 20% coinsurance, and ambulatory surgical center services have a coinsurance between 0% and 20%. Individual sessions for outpatient substance abuse have a coinsurance between 0% and 20%, while group sessions have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are covered, with 36 one-way trips per year, and no copay. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45, and there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a 20% coinsurance, and Occupational Therapy Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services have a 0-20% coinsurance. Individual and Group Sessions for Mental Health Specialty Services have a 0-20% coinsurance, and Individual and Group Sessions for Psychiatric Services have a 0-20% coinsurance. Podiatry Services have a 20% coinsurance, and Routine Foot Care is not covered. Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
The UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, although specific services such as health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan covers vision services, including routine eye exams and eyewear. Routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames have no copay, and eyeglasses (lenses and frames) and upgrades are not covered. Eyewear has a combined maximum plan benefit coverage amount of $200 every year.
Dental Services See details
Dental services are covered, including Medicare dental services with 20% coinsurance, oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery with no copay. 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 with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
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, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance, while Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
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 Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay, and Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete PA-S3 (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 by the UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan, but none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but this plan does not offer Skilled Nursing Facility Services as a supplemental benefit under Part C. The plan does not cover additional days beyond Medicare-covered for SNF, nor does it cover Non-Medicare-covered stays for SNF.
Other Services See details
The UHC Dual Complete PA-S3 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with no copay, and Meal Benefits with no copay, but 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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