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UHC Dual Complete GA-V001 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete GA-V001 (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-V001 (PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete GA-V001 (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-V001 (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-V001 (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-V001 (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-V001 (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 $1.30. 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 $10100.00 (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 $10100.00 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-V001 (PPO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you will pay $40.00 for Part D. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete GA-V001 (PPO D-SNP) plan offers a range of benefits with varying costs. For inpatient hospital stays, you can expect a copay, but for days 8-90, there is no copay. Outpatient services have copays between $0 and $395, and ambulance services have a $290 copay. Emergency services have a $125 copay, while many primary care and preventive services have no copay. This plan also includes coverage for hearing, vision, and dental services. Hearing exams are covered with no copay, while prescription hearing aids have a copay. Vision services include eye exams and contact lenses with no copay. Dental services include a 20% coinsurance for Medicare Dental Services and a maximum benefit of $1000 per year for other dental services. Additionally, the plan covers home health services, skilled nursing facility stays, and provides over-the-counter items and a meal benefit with no copay.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care, with a copay of $395 for days 1-7 and days 1-5, respectively, and no copay for days 8-90 and 6-90, respectively. Additional days for inpatient hospital psychiatric are not covered, and non-Medicare-covered stays and upgrades for inpatient hospital acute are not covered.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services, with a copay between $0 and $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services has individual sessions with a copay between $0 and $25, and group sessions with a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete GA-V001 (PPO D-SNP) plan. Ground and Air Ambulance Services have a $290 copay, while Transportation Services to a plan-approved health-related location are covered with no copay for up to 24 one-way trips per year. Transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Dual Complete GA-V001 (PPO D-SNP) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $45, while Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Dual Complete GA-V001 (PPO D-SNP) plan covers primary care physician services with no copay, and chiropractic services with a $20 copay. Occupational therapy services, physician specialist services, and physical therapy and speech-language pathology services have copays ranging from $0-$10. Mental health specialty services, and psychiatric services have a copay of $0-$25 for individual sessions, and a $15 copay for group sessions. Podiatry services, other health care professional, additional telehealth benefits, and opioid treatment program services have a $0-$10 copay.
Preventive Services See details
Preventive services include coverage for Medicare-covered preventive services, annual physical exams with no copay, and additional preventive services. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, and enhanced disease management. The plan also covers Fitness Benefit, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, and Other Preventive Services with no copay.
Hearing Services See details
Hearing Services includes hearing exams with no copay, and routine hearing exams with no copay for one visit every year. Prescription hearing aids have a copay between $199 and $1249 for two visits every year, and OTC hearing aids have a copay between $99 and $829 for two hearing aids every year. 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
The UHC Dual Complete GA-V001 (PPO D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and contact lenses have no copay, and eyeglasses have a copay of $0-$153. Eyeglasses (lenses and frames) are not covered, and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare Dental Services with a 20% coinsurance, while other dental services have a maximum benefit of $1000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. Prosthodontics, removable and fixed, have a coinsurance between 0% and 50%. Orthodontic and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The plan covers Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the UHC Dual Complete GA-V001 (PPO D-SNP) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies has no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
The UHC Dual Complete GA-V001 (PPO D-SNP) plan covers Diagnostic and Radiological Services, including diagnostic procedures and tests with a $45 copay. Lab services have no copay, while diagnostic radiological services have a copay up to $240, and outpatient X-rays have a $20 copay. Therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete GA-V001 (PPO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete GA-V001 (PPO 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, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203.
Other Services See details
The UHC Dual Complete GA-V001 (PPO D-SNP) plan covers Over-the-Counter (OTC) Items with no copay, and also provides a meal benefit with no copay, but requires prior authorization. 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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