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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 $0.50. 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 features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for 1-month and 3-month supplies at standard pharmacies, as well as for 3-month standard mail orders. This coverage ensures affordable access to everyday maintenance medications. For Tier 2 generic and Tier 3 preferred brand drugs, you will pay a 25% coinsurance for both 1-month and 3-month supplies. Tier 4 non-preferred drugs and Tier 5 specialty drugs also require a 25% coinsurance for 1-month supplies at standard pharmacies and mail order.
Additional Benefits
The UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan offers robust healthcare coverage, featuring no copays for primary, specialist, and preventative care, with coinsurance ranging up to 20%. Inpatient hospital stays require a $2,000 copay per admission with no coinsurance, while outpatient services feature no copays and coinsurance up to 20%. Emergency services carry a $115 copay that is waived if admitted, while urgently needed care ranges from no copay to $40. For supplemental care, the plan offers dental, vision, and home health services with no copay and no coinsurance, including a $200 annual eyewear allowance. Hearing aids and up to 12 one-way transportation trips per year to plan-approved locations are also covered with no copays. Additionally, durable medical equipment, prosthetics, and dialysis services are available with no copay and 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $2,000 copay per admission, no coinsurance, and required prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copays, though coinsurance ranging from no coinsurance to 20% applies to outpatient hospital, ambulatory surgical, and substance abuse services. Outpatient blood services are also covered with no copay and 20% coinsurance, and the deductible is waived for the first three pints.
Partial Hospitalization See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 12 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered under the UHC Dual Complete NY-S002 (HMO-POS D-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 feature a copay of $0 to $40 with 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, specialist, and mental health care with no copay and coinsurance ranging from no coinsurance to 20%. Therapy and routine podiatry services require no copay and 20% coinsurance, while chiropractic benefits are partially covered with routine care costing no copay and 20% coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP), offering no copay and no coinsurance for annual physicals, kidney disease education, and fitness benefits. A 20% coinsurance applies to digital rectal exams and post-welcome visit EKGs, while excluded sub-services include health education, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) hearing services are partially covered, offering one annual routine hearing exam with 20% coinsurance and no copay, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay or coinsurance, providing up to $2,200 for prescription aids and up to two OTC devices every two years, 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 Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and no coinsurance for covered benefits, including one routine eye exam per year and a $200 annual allowance for eyewear like contact lenses, eyeglass lenses, and frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered by the plan.
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, subject to prior authorization. Preventive and comprehensive dental services, including cleanings, x-rays, restorative care, and orthodontics, are covered with no copay and no coinsurance, though prior authorization is required for comprehensive treatments.
Home Infusion bundled Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers home infusion bundled services with no copay, requiring prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment benefits under UHC Dual Complete NY-S002 (HMO-POS D-SNP) are covered with no copay and 20% coinsurance for 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 services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with prior authorization, featuring no copay and no coinsurance for diagnostic radiological services. Diagnostic tests require a copay and 20% coinsurance, lab services require coinsurance with no copay, and both therapeutic radiology and outpatient X-rays require 20% coinsurance with no copay.
Home Health Services See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered by UHC Dual Complete NY-S002 (HMO-POS D-SNP) with no copay and prior authorization required. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered under the plan and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete NY-S002 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under the UHC Dual Complete NY-S002 (HMO-POS D-SNP) plan are partially covered, offering acupuncture limited to 12 treatments per year, over-the-counter items, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, while highly integrated services and other unspecified services are not covered by the plan.
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