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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 2025, 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 3.5 out of 5 stars in 2025.
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 $72.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.30. 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 $9350.00 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) plan has a $590.00 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2000.00. If you qualify for the low-income subsidy (LIS), your monthly premium will be $72.30. Once your yearly out-of-pocket drug costs reach $2000.00, you will enter the catastrophic coverage phase, where you will pay nothing for covered Part D drugs.
Additional Benefits
The UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan offers comprehensive coverage with a variety of benefits. This plan includes inpatient and outpatient services, with varying cost-sharing. Many services have no copay, including preventive services, routine hearing exams, vision exams, and many dental services. The plan also offers coverage for emergency services, ambulance, and transportation services, with specific copays and coinsurance amounts. You can expect no copay for home health services, OTC items, and meal benefits. However, some services, such as inpatient hospital stays and partial hospitalization, have specific copays, while some services have coinsurance between 0% and 20%.
Inpatient Hospital See details
Inpatient Hospital benefits include Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization, with a copay of $1970 per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a 0% - 20% coinsurance, observation services with 20% coinsurance, ambulatory surgical center services with a 0% - 20% coinsurance, outpatient substance abuse services with a 0% - 20% coinsurance for individual sessions and 20% coinsurance for group sessions, and outpatient blood services with a 20% coinsurance. This plan waives the three-pint deductible for outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, 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, with a 20% coinsurance for both ground and air ambulance services. Transportation services to a plan-approved health-related location have no copay, and are limited to 36 one-way trips per year via taxi or medical transport; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, under the UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan, have a $110 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $45, and no coinsurance. Worldwide Emergency Services are covered with a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, and no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with coinsurance between 0% and 20%. Chiropractic Services are covered with 20% coinsurance, but routine care is not covered. Podiatry Services are covered with 20% coinsurance and no copay, while Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services. Additional preventive services, including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, 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 include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have a coinsurance of 20% and routine hearing exams are limited to one per year with no copay, while fitting/evaluation for hearing aids are not covered. Prescription hearing aids have no copay, are limited to two per year, and have a maximum plan benefit coverage of $2200. OTC hearing aids have no copay and are limited to two per year.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams, routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan covers dental services, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay. Other services such as 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, but require prior authorization. For Medicare Part B Insulin Drugs, you pay a $35 copay and between 0% and 20% coinsurance, depending on the drug. Other Medicare Part B drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of at most 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of at most 20% (minimum 0%), Therapeutic Radiological Services with a coinsurance of at most 20% (minimum 20%), and Outpatient X-Ray Services with a coinsurance of at most 20% (minimum 20%). Prior authorization is required.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and no coinsurance; however, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered SNF stays or non-Medicare-covered SNF stays. Prior authorization is required, and you will pay the Medicare-defined cost share.
Other Services See details
The UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan's "Other Services" benefit covers Over-the-Counter (OTC) Items and Meal Benefits with no copay, but it does not cover Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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