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UHC Complete Care NY-30 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care NY-30 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care NY-30 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care NY-30 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in New York. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care NY-30 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care NY-30 (HMO-POS C-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 Complete Care NY-30 (HMO-POS C-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 Complete Care NY-30 (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $440.00 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 Maximum Out-Of-Pocket cost of $8300.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 Complete Care NY-30 (HMO-POS C-SNP) Medicare plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for standard retail pharmacies or mail-order options. Tier 2 generic drugs cost an $8 copay for a 1-month supply at a standard pharmacy, but you can secure a 3-month supply with no copay through preferred mail order. For higher-tier medications, this plan transitions to coinsurance costs instead of flat copays. Tier 3 preferred brand drugs require a 21% coinsurance for both standard pharmacies and mail-order options. Tier 4 non-preferred drugs carry a 40% coinsurance, while Tier 5 specialty drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The UHC Complete Care NY-30 (HMO-POS C-SNP) plan offers comprehensive coverage for core medical needs, featuring no copay and no coinsurance for primary care, telehealth, and preventive visits. For emergency care, members pay a $115 copay, which is waived upon hospital admission, while inpatient hospital stays require a $455 daily copay for the first few days before transitioning to no copay. Standard diagnostic lab tests and diagnostic radiology are also fully covered with no copays. Routine vision, hearing, and preventive dental care are highly accessible with no copays, though comprehensive dental treatments and cardiac rehabilitation are not covered by this plan. Additional benefits include a $250 eyewear allowance every two years, home health services, and over-the-counter items with no copays. For major medical needs like dialysis and durable medical equipment, members will pay a 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Complete Care NY-30 (HMO-POS C-SNP) with no coinsurance, though upgrades and non-Medicare-covered stays are not covered. Acute care requires a $455 copay per day for days 1 to 5 and no copay for additional days, while psychiatric care requires a $455 copay per day for days 1 to 4 and no copay for days 5 to 90.
Outpatient Services See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers outpatient services with no coinsurance, though prior authorization is required. Outpatient hospital and observation services carry copays of $0 to $455, outpatient substance abuse sessions range from a $0 to $25 copay, and ambulatory surgical center and blood services have no copays.
Partial Hospitalization See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency Services are covered under the UHC Complete Care NY-30 (HMO-POS C-SNP) plan with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care NY-30 (HMO-POS C-SNP) offers primary care and telehealth services with no copay and no coinsurance. Other covered benefits, including specialist visits, physical therapy, and mental health services, feature no coinsurance and copays ranging from $0 to $30, though routine chiropractic care is not covered.
Preventive Services See details
Preventive services are partially covered by UHC Complete Care NY-30 (HMO-POS C-SNP) with no copays and no coinsurance for covered services like annual physicals, fitness benefits, and home safety devices. Sub-services not covered under this benefit include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care NY-30 (HMO-POS C-SNP), offering one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams 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 ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Complete Care NY-30 (HMO-POS C-SNP) with no coinsurance and no deductibles, offering one routine eye exam per year with no copay. Eyewear is covered up to a $250 combined limit every two years with no copay for contacts and frames, and a $0 to $153 copay for lenses, while other eye exams, upgrades, and bundled eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Complete Care NY-30 (HMO-POS C-SNP), offering Medicare-covered dental care with no copay and 20% coinsurance, as well as routine preventive services like exams, cleanings, and X-rays with no copay and no coinsurance. Comprehensive dental treatments, including restorative, endodontics, periodontics, prosthodontics, implants, and oral surgery, are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Complete Care NY-30 (HMO-POS C-SNP) with no copay, though prior authorization and step therapy are required. Medicare Part B drugs associated with these services, including chemotherapy and insulin, are subject to a 0% to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers durable medical equipment and prosthetics with no copay and 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are also covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Complete Care NY-30 (HMO-POS C-SNP), with prior authorization required. Members pay a $50 copay and no coinsurance for diagnostic tests, a $25 copay for outpatient X-rays, a 20% coinsurance for therapeutic radiology, and no copay for lab services and diagnostic radiology.
Home Health Services See details
UHC Complete Care NY-30 (HMO-POS C-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 by the UHC Complete Care NY-30 (HMO-POS C-SNP) plan, as none of the sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered in practice.
Skilled Nursing Facility (SNF) See details
UHC Complete Care NY-30 (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage for days beyond the Medicare-covered limit.
Other Services See details
UHC Complete Care NY-30 (HMO-POS C-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered, and prior authorization is required for the meal benefit.
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