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UHC Dual Complete NY-S002 (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-S002 (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-S002 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NY-S002 (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-S002 (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-S002 (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-S002 (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-S002 (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. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 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-S002 (HMO-POS D-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly accessible, featuring no copay for one-month and three-month supplies at standard pharmacies, as well as no copay for three-month standard mail orders. For Tier 2 generic and Tier 3 preferred brand medications, you will pay a 25% coinsurance for both one-month and three-month fills at standard pharmacies and mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply through standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring no copays for primary care visits, outpatient hospital services, and home health care, though coinsurance up to 20% may apply to some specialist and outpatient services. Inpatient hospital stays require a copay of $2,110 per stay for acute care and $2,080 per stay for psychiatric care, both with no coinsurance. Emergency room visits carry a $115 copay, which is waived if you are admitted within 24 hours, while routine transportation and telehealth services are available with no copays. This plan also provides valuable dental, vision, and hearing benefits, offering routine exams and preventive care with no copays. Members receive up to a $200 annual allowance for eyewear and up to $2,200 every two years for prescription hearing aids, both with no copay or coinsurance. Additionally, there are no copays for skilled nursing facility care, over-the-counter items, and chronic illness meal benefits, though a 20% coinsurance applies to durable medical equipment and dialysis services.
Inpatient Hospital See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,110 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. The benefit is partially covered because hospital upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered, though unlimited additional acute care days are covered with no copay.
Outpatient Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers outpatient services with no copay, though prior authorization and coinsurance ranging from no coinsurance up to 20% may apply. Covered benefits—including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services—all feature no copay, with coinsurance varying by the specific service.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete NY-S002 (HMO-POS 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 NY-S002 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Routine transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete NY-S002 (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 copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers primary care, specialist, and mental health services with no copays and coinsurance ranging from no coinsurance up to 20%, while chiropractic services are not covered. Telehealth and opioid treatment program services are fully covered with no copays and no coinsurance.
Preventive Services See details
Preventive services under UHC Dual Complete NY-S002 (HMO-POS D-SNP) are partially covered, featuring no copay and no coinsurance for annual physicals, kidney disease education, fitness programs, and caregiver support. However, a 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs, and several supplemental services like health education and personal emergency response systems are not covered.
Hearing Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) features partially covered hearing exams, offering one annual routine exam with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Up to two OTC hearing aids every two years are covered with no copay or coinsurance, and while some prescription hearing aid services are covered up to $2,200 every two years with no copay or coinsurance, inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and no coinsurance for one routine eye exam per year and eyewear up to a $200 annual limit, which covers contact lenses, eyeglass lenses, and eyeglass frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers Medicare-covered dental services with no copay and a 20% coinsurance. All other preventive and comprehensive dental services, including cleanings, exams, and orthodontic services, are covered with no copay and no coinsurance, though prior authorization is required for some services.
Home Infusion bundled Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Medicare Part B drugs, including chemotherapy and insulin, carry no coinsurance to 20% coinsurance, with insulin requiring an additional $35 copay.
Dialysis Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copays. A 20% coinsurance applies to DME, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Dual Complete NY-S002 (HMO-POS D-SNP) with prior authorization, featuring no copay for lab services and no copay or coinsurance for diagnostic radiology. Outpatient X-rays, therapeutic radiology, and diagnostic tests require a 20% coinsurance, with diagnostic tests also requiring a copay.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under UHC Dual Complete NY-S002 (HMO-POS D-SNP), as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all not covered. These services require a 20% coinsurance and no copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. The plan allows for SNF admission without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP), offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and dual eligible SNPs with highly integrated services are not covered, and prior authorization is required for the meal benefit.
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