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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 $0.90. 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:
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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 a 1-month or 3-month supply at standard pharmacies and standard mail order. Tier 2 generic drugs require a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and mail order. Tier 3 preferred brand drugs also carry a 25% coinsurance for 1-month and 3-month supplies. For Tier 4 non-preferred drugs and Tier 5 specialty drugs, members pay a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. This plan offers a clear cost structure to help you manage your monthly medication expenses.
Additional Benefits
The UHC Dual Complete GA-V1 (PPO D-SNP) offers comprehensive medical coverage featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $485 for the first few days and no copay thereafter, while outpatient hospital services require copays up to $485. Specialist visits, mental health sessions, and diagnostic tests are highly affordable, with copays ranging from no copay up to $40. This plan also provides valuable supplemental benefits, including routine vision and preventive dental care with no copays, alongside a $150 eyewear allowance and up to $1,000 in annual dental services. Durable medical equipment, dialysis, and Medicare Part B drugs generally require a 20% coinsurance with no copays. Additionally, members can access convenient extras like over-the-counter items, meals, and up to 24 one-way transportation trips per year with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Complete GA-V1 (PPO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $485 for days 1 to 5 of acute stays (no copay for days 6 and beyond) and days 1 to 4 of psychiatric stays (no copay for days 5 to 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and blood services. Outpatient hospital and observation services have copays ranging up to $485, while outpatient substance abuse sessions require copays between $0 and $25.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete GA-V1 (PPO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers ground and air ambulance services with a $290 copay and no coinsurance, subject to prior authorization. Transportation benefits are partially covered with no copay or coinsurance, offering up to 24 one-way taxi or medical transport trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete GA-V1 (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 and no coinsurance, while worldwide emergency care, urgent care, and emergency transportation are covered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers primary care provider visits and telehealth services with no copay and no coinsurance. Specialist visits, physical therapy, and mental health services are covered with copays ranging from $0 to $25 and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, diabetes training, and fitness benefits. Additional preventive services are only partially covered, with exclusions for health education, in-home safety assessments, medical nutrition therapy, alternative therapies, and nutritional or dietary benefits.
Hearing Services See details
Hearing services offered by UHC Dual Complete GA-V1 (PPO D-SNP) are partially covered, featuring no copay or coinsurance for one routine hearing exam annually, while hearing aid fittings and evaluations are not covered. Prescription and OTC hearing aids are covered for up to two devices per year with no coinsurance and copays ranging from $199.00 to $1,249.00, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers one routine eye exam per year and select eyewear with no coinsurance and generally no copay, except for eyeglass lenses which have a copay of $0 to $153. Covered eyewear, including contact lenses and frames, has a combined maximum benefit of $150 every two years, while other eye exams, upgrades, and packaged eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete GA-V1 (PPO D-SNP), with implant services and orthodontics excluded from coverage. Preventive care has no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered services require a 20% coinsurance and comprehensive services require a 50% coinsurance, both with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Dual Complete GA-V1 (PPO D-SNP) with no copay, though prior authorization is required. Medicare Part B drugs, including chemotherapy and insulin, are covered with a coinsurance of 0% to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete GA-V1 (PPO D-SNP) plan 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 most services.
Diagnostic and Radiological Services See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests require a $40 copay with no coinsurance, outpatient x-rays have a $25 copay, therapeutic radiology has a 20% coinsurance, and both lab services and diagnostic radiology are offered with no copay.
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
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete GA-V1 (PPO D-SNP) plan, as all individual sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered in practice.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete GA-V1 (PPO D-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance and does not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard 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 with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered under this plan.
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* 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.
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