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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 2025, 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 3.5 out of 5 stars in 2025.
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 $72.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.70. 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 $590.00 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 $8850.00 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) plan has a $590 deductible for prescription drugs. After meeting the deductible, your cost-sharing for drugs will vary depending on the drug tier and pharmacy. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you have full LIS, you'll pay $72.30 for Part D.
Additional Benefits
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing. Many services, such as primary care, preventive services, home health, and dental cleanings, have no copay. However, some services like emergency care, outpatient substance abuse, and dialysis services may have copays or coinsurance, so it is important to understand the specifics of the plan. Inpatient hospital stays and outpatient services also have coverage, with no copay for many services, but with coinsurance for ambulance services and some diagnostic services. The plan also includes coverage for hearing and vision services, with no copay for eye exams and vision wear, but with some services like hearing exams requiring coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, there is no copay for a Medicare-covered stay and for additional days between 91-999, there is no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, and ambulatory surgical center services with no copay. Outpatient Substance Abuse services are covered with a coinsurance between 0-20% for individual sessions and 20% for group sessions, and outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan. Both ground and air ambulance services are covered with a 20% coinsurance, and there is no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan covers primary care physician services, occupational therapy services, physician specialist services, additional telehealth benefits, and physical therapy and speech-language pathology services with no copay. Chiropractic services are partially covered with 20% coinsurance, while routine chiropractic care is not covered. Mental health specialty services and psychiatric services are partially covered with coinsurance between 0% and 20% depending on the service. Other health care professional and opioid treatment program services are covered with no copay. Podiatry services are not covered.
Preventive Services See details
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, such as Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas, have no copay, while Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered under the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan, with routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids (all types, inner ear, outer ear, and over the ear) not covered, and a coinsurance of at most 20% for hearing exams. Over-the-counter hearing aids are not covered.
Vision Services See details
Vision services include eye exams with no copay, however, routine eye exams are not covered. Eyewear services are also covered with no copay, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan covers Medicare and other dental services, with some services requiring prior authorization. Medicare dental services have a 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, but the number of visits and periodicity will vary by service. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan. This plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
The UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan covers Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices and Medical Supplies with a 20% coinsurance, and Diabetic Supplies with no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of up to 20%, while Diagnostic Radiological Services have a coinsurance of 0-20%. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered for SNF, and does not cover non-Medicare-covered stays for SNF.
Other Services See details
Other Services for the UHC Dual Complete NY-Y001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, and Meal Benefits also have no copay, but require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and all other listed services are not covered.
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