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UHC Dual Complete GA-S1 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete GA-S1 (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-S1 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete GA-S1 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Select Counties in Georgia. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete GA-S1 (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-S1 (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-S1 (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-S1 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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:
Sign up for UHC Dual Complete GA-S1 (PPO D-SNP)
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Drug Coverage
The UHC Dual Complete GA-S1 (PPO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drug coverage, Tier 1 preferred generic drugs offer no copay for one-month and three-month supplies at standard pharmacies, as well as three-month standard mail orders. This helps keep essential generic medications highly affordable for plan members. For other drug tiers, members generally pay a 25% coinsurance for their prescriptions. This 25% coinsurance applies to Tier 2 generic drugs, Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty medications filled through standard pharmacies or standard mail order. Knowing these coinsurance rates and the annual deductible can help you accurately estimate your yearly out-of-pocket prescription drug costs.
Additional Benefits
The UHC Dual Complete GA-S1 (PPO D-SNP) plan offers comprehensive medical coverage with no copays for primary care visits, specialist consultations, home health services, and skilled nursing facility stays. For inpatient hospital services, members pay no coinsurance but are responsible for a copay of $2,215 per stay for acute care and $2,080 per stay for psychiatric care. Emergency room visits require a $115 copay, which is waived if admitted, while outpatient care and diagnostic labs are available with no copay and coinsurance up to 20 percent. Supplemental benefits include routine vision and dental care with no copays or coinsurance, featuring up to a $2,500 annual limit for comprehensive dental services. Members also benefit from a $1,500 hearing aid allowance every two years, no-copay routine hearing exams, and up to 24 one-way transportation trips annually with no copay or coinsurance. Additionally, essential everyday benefits like over-the-counter items and chronic illness meals are covered with no copays or coinsurance.
Inpatient Hospital See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,215 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. This benefit is partially covered, as unlimited additional acute care days are provided with no copay, but upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete GA-S1 (PPO D-SNP) with no copay, though coinsurance ranges from no coinsurance up to 20% depending on the service. Covered benefits include outpatient hospital care, ambulatory surgical center services, substance abuse therapy, and blood services, most of which require prior authorization.
Partial Hospitalization See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, while transportation services are partially covered. Eligible members receive up to 24 one-way trips per year to plan-approved health-related locations via taxi or medical transport with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care, specialist, and mental health services under UHC Dual Complete GA-S1 (PPO D-SNP) are covered with no copay and coinsurance ranging from no coinsurance to 20%, while chiropractic services are not covered. Therapy services require no copay and 20% coinsurance, whereas telehealth and opioid treatment are available with no copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered under the UHC Dual Complete GA-S1 (PPO D-SNP) plan, offering no copay and no coinsurance for annual physicals, kidney disease education, fitness benefits, and home safety devices. However, a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs, and several services—including health education, personal emergency response systems, and nutritional counseling—are not covered.
Hearing Services See details
Hearing Services are partially covered by UHC Dual Complete GA-S1 (PPO D-SNP), featuring one routine hearing exam annually with no copay and a 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids are also partially covered with no copay or coinsurance up to a $1,500 limit every two years, excluding inner ear, outer ear, and over-the-ear models. Additionally, up to two OTC hearing aids are covered every two years with no copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Dual Complete GA-S1 (PPO D-SNP), featuring routine eye exams and eyewear with no copay and no coinsurance. Covered benefits include one routine exam per year and up to $200 annually for contact lenses, eyeglass lenses, and frames, though other eye exams, upgrades, and packaged eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete GA-S1 (PPO D-SNP), featuring Medicare-covered dental services with no copay and a 20% coinsurance. Other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,500 annual limit, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete GA-S1 (PPO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete GA-S1 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete GA-S1 (PPO D-SNP) with prior authorization required. Diagnostic procedures and tests require a copay and 20% coinsurance, while lab services have no copay; radiological services feature no copay, with no coinsurance for diagnostic radiology and 20% coinsurance for therapeutic and outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete GA-S1 (PPO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers Cardiac Rehabilitation Services with no copay and 20% coinsurance, though prior authorization is required. Some services are covered, but standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete GA-S1 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required and admission does not require a prior three-day hospital stay. This benefit is partially covered because additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services under UHC Dual Complete GA-S1 (PPO D-SNP) are partially covered, with acupuncture not covered. Over-the-counter (OTC) items and chronic illness meal benefits are covered with no copay and no coinsurance, though meal benefits require prior authorization.
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