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UHC Dual Complete NY-Y001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NY-Y001 (HMO-POS 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 NY-Y001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) is a HMO-POS D-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 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete NY-Y001 (HMO-POS 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 NY-Y001 (HMO-POS 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 NY-Y001 (HMO-POS 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 NY-Y001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $58.80. 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 $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 Maximum Out-Of-Pocket cost of $9250.00 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 Dual Complete NY-Y001 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members enjoy no copay for a 1-month or 3-month supply at standard pharmacies, as well as no copay for a 3-month supply via standard mail order. This plan provides a cost-effective option for individuals seeking coverage for essential generic medications. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance for standard pharmacy and mail order fills. This 25% coinsurance applies to 1-month and 3-month supplies for Tiers 2 and 3, and to 1-month supplies for Tiers 4 and 5. Knowing these cost-sharing percentages helps you easily estimate your out-of-pocket prescription expenses.
Additional Benefits
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) offers robust medical coverage with no copays for primary care, telehealth, outpatient services, and home health care. Inpatient hospital stays require a $1,985 copayment per stay with no coinsurance, while emergency room visits have a $115 copay that is waived if you are admitted. Most outpatient care, dialysis, and durable medical equipment feature no copays but require a 20% coinsurance. For extra benefits, preventive and comprehensive dental care are fully covered with no copays or coinsurance. Members also enjoy no copays on diagnostic radiology, lab tests, and over-the-counter items, though routine vision exams, eyeglasses, and hearing aids are not covered. Many specialized services and equipment under this plan will require prior authorization.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete NY-Y001 (HMO-POS D-SNP) with no coinsurance and a $1,985 copayment per stay for Medicare-covered acute and psychiatric admissions. Unlimited additional acute days are covered with no copay or coinsurance, but non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by UHC Dual Complete NY-Y001 (HMO-POS D-SNP) feature no copays, with coinsurance ranging from no coinsurance up to 20% depending on the specific service. Covered benefits include outpatient hospital, ambulatory surgical center, substance abuse, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete NY-Y001 (HMO-POS D-SNP) 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 NY-Y001 (HMO-POS D-SNP), offering ground and air ambulance services with a 20% coinsurance, no copay, and required prior authorization. However, transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Dual Complete NY-Y001 (HMO-POS 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 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
Primary Care benefits under UHC Dual Complete NY-Y001 (HMO-POS D-SNP) feature no copays for all covered services, with coinsurance ranging from 0% to 20% for primary care, specialists, and mental health, and a flat 20% coinsurance for physical, occupational, and speech therapies. Telehealth and opioid treatment services are available with no copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, kidney disease education, fitness benefits, and in-home support. Additional preventive services are only partially covered, with exclusions on items like health education and personal emergency response systems, and a 20% coinsurance required for digital rectal exams and post-welcome visit EKGs.
Hearing Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) covers hearing exams with no copay, no coinsurance, and no deductible, though prior authorization is required and routine exams and fitting evaluations are not covered. Some prescription hearing aid services are covered, but OTC hearing aids and all prescription hearing aid types—including inner ear, outer ear, and over the ear—are not covered.
Vision Services See details
Vision services are covered under UHC Dual Complete NY-Y001 (HMO-POS D-SNP) with no deductible, copay, or coinsurance. However, in practice only some services are covered, as routine eye exams, other eye exam services, contact lenses, eyeglasses, and upgrades are not covered.
Dental Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) covers Medicare-approved dental services with no copay and a 20% coinsurance. Preventive and comprehensive dental services, including exams, cleanings, implants, and orthodontics, are covered with no copay and no coinsurance, although prior authorization is required for comprehensive care.
Home Infusion bundled Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-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 Dual Complete NY-Y001 (HMO-POS D-SNP) covers medical equipment with no copay, but a 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures require a copay and a minimum 20% coinsurance, while lab services have no copay. Radiological services have no copay, featuring no coinsurance for diagnostic radiology and a minimum 20% coinsurance for therapeutic and outpatient X-ray services.
Home Health Services See details
UHC Dual Complete NY-Y001 (HMO-POS 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 offered by UHC Dual Complete NY-Y001 (HMO-POS D-SNP) with no copay and require prior authorization. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete NY-Y001 (HMO-POS D-SNP) with no copayment and no coinsurance, though prior authorization is required. Admission is allowed without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete NY-Y001 (HMO-POS D-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 under this plan, and the meal benefit requires prior authorization.
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