A non-government entity
UHC Dual Complete GA-V1 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete GA-V1 (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-V1 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete GA-V1 (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-V1 (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-V1 (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-V1 (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-V1 (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-V1 (PPO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete GA-V1 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members benefit from no copay for 1-month and 3-month supplies at standard pharmacies, as well as for 3-month standard mail orders. This plan offers an affordable pathway for filling basic, everyday generic prescriptions. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to standard pharmacy and standard mail order fills for both short-term and extended supplies depending on the specific tier. Understanding these cost-sharing tiers helps you accurately budget your yearly healthcare expenses.
Additional Benefits
The UHC Dual Complete GA-V1 (PPO D-SNP) plan provides robust medical coverage with no copays for primary care, telehealth, and annual preventive physicals. Members pay a copay ranging from no copay to $20 for specialist visits, while emergency room visits require a $115 copay that is waived if admitted. Inpatient hospital stays require a $485 copay for the first few days with no copay thereafter, and outpatient hospital services range from no copay up to a $485 copay. This plan also includes valuable supplemental benefits, such as routine dental, vision, and hearing exams with no copays, alongside allowances for eyewear and hearing aids. Skilled nursing facility stays feature no copay for the first 20 days, while durable medical equipment and dialysis services require a 20% coinsurance. Additionally, members benefit from covered home health services, over-the-counter items, and chronic illness meals with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Complete GA-V1 (PPO D-SNP) inpatient hospital benefits are partially covered with no coinsurance, requiring a $485 copay for days 1 through 5 of acute stays and days 1 through 4 of psychiatric stays, with no copay for subsequent covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers outpatient services with no coinsurance, including outpatient hospital services with a copay of $0 to $485 and daily observation services with a $485 copay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services carry no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
UHC Dual Complete GA-V1 (PPO 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
Ambulance and transportation services are covered by UHC Dual Complete GA-V1 (PPO D-SNP), with ground and air ambulance services requiring a $290 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete GA-V1 (PPO D-SNP) with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
Primary care benefits under UHC Dual Complete GA-V1 (PPO D-SNP) are covered with no copay and no coinsurance for primary care provider visits and telehealth, while specialist visits require a $0 to $20 copay and no coinsurance. Therapy and podiatry services have a $20 copay with no coinsurance, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, offering fitness benefits and in-home support, while services such as health education, nutritional counseling, and personal emergency response systems are not covered.
Hearing Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) offers partially covered hearing services, including one annual routine exam with no copay and no coinsurance, though fitting evaluations are not covered. The plan also covers up to two prescription hearing aids (copays of $199.00 to $1,249.00) and two OTC hearing aids (copays of $199.00 to $829.00) annually with no coinsurance, though inner, outer, and over-the-ear prescription models are excluded.
Vision Services See details
Vision services are partially covered by UHC Dual Complete GA-V1 (PPO D-SNP) with no deductible or coinsurance, featuring one routine eye exam per year with no copay, while other eye exam services are not covered. Eyewear is also partially covered up to a combined $150 limit every two years, offering contact lenses and frames with no copay, and lenses with a $0 to $153 copay, though upgrades and combined eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete GA-V1 (PPO D-SNP), excluding implant services and orthodontics. Diagnostic and preventive services have no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered services require no copay and 20% coinsurance, and other covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs require a coinsurance ranging from no coinsurance to 20%, with Part B insulin drugs having a $35 copay.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete GA-V1 (PPO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 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
UHC Dual Complete GA-V1 (PPO D-SNP) covers diagnostic services with no coinsurance, featuring lab services with no copay and diagnostic tests for a $40 copay. Covered radiological services include diagnostic radiology with no copay, outpatient X-rays for a $25 copay, and therapeutic radiology with a 20% coinsurance.
Home Health Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers Cardiac Rehabilitation Services with no copay, no coinsurance, and prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day inpatient hospital stay requirement, though prior authorization is required. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved