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UHC Dual Complete GA-S001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete GA-S001 (PPO 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 GA-S001 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete GA-S001 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Georgia. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete GA-S001 (PPO 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 GA-S001 (PPO 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 GA-S001 (PPO 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 GA-S001 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.10. 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 combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 GA-S001 (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay costs for your drugs, but the specific amounts are not provided. Once your total drug costs reach $2000, you will enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you will pay $40 per month for your Part D drugs. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete GA-S001 (PPO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $1955 copay, while outpatient services and primary care have coinsurance between 0% and 20%. Emergency services have a $110 copay, and ambulance services have a 20% coinsurance. This plan provides several services with no copay, including preventive services, hearing exams, vision exams, dental services, home health services, over-the-counter items, and meal benefits. Additionally, the plan covers transportation services, prescription hearing aids, and durable medical equipment with associated costs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $1955 per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, while Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Observation Services have a 20% coinsurance, while outpatient hospital services have a coinsurance between 0% and 20%. Ambulatory Surgical Center (ASC) Services have a coinsurance between 0% and 20%, and Outpatient Substance Abuse Services, including individual and group sessions, have no copay. Outpatient Blood Services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services with a 20% coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, up to 36 one-way trips per year.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. For Emergency Services, you will pay a $110 copay, and for Urgently Needed Services, the copay is between $0 and $45. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The UHC Dual Complete GA-S001 (PPO D-SNP) plan covers primary care physician services with a coinsurance of 0% to 20%, chiropractic services with 20% coinsurance, occupational therapy services with 0% to 20% coinsurance, and physician specialist services with 0% to 20% coinsurance. This plan also covers mental health specialty services, podiatry services, other health care professional services with 0% to 20% coinsurance, psychiatric services, physical therapy and speech-language pathology services with 0% to 20% coinsurance, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
The UHC Dual Complete GA-S001 (PPO D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, such as Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas, have no copay, while Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year with no copay. Prescription hearing aids have a maximum benefit of $1500 per year with no copay, and OTC hearing aids are covered with no copay. Fitting/Evaluation for Hearing Aid, 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 are covered, including eye exams and eyewear. Eye exams and contact lenses have no copay, and routine eye exams are limited to one per year. Eyeglass lenses and frames are covered, with a limit of one per year, and eyewear has a combined maximum benefit of $200 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered under the UHC Dual Complete GA-S001 (PPO D-SNP) plan. Medicare Dental Services, 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), and Oral and Maxillofacial Surgery are covered with no copay, while Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0-20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%. Prior authorization is required.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), is covered with a 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Prosthetic devices and medical supplies are covered with a 20% coinsurance, and Diabetic Equipment is covered. 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. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20% and at least 20%, respectively. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete GA-S001 (PPO 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 not covered by the UHC Dual Complete GA-S001 (PPO D-SNP) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. The plan requires prior authorization, and the copay is determined by Medicare.
Other Services See details
The UHC Dual Complete GA-S001 (PPO D-SNP) plan covers over-the-counter items and meal benefits with no copay, while acupuncture is not covered. Additional services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, Private Duty Nursing Services, and more are also not covered.
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