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UHC Dual Complete NY-Q001 (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-Q001 (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-Q001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NY-Q001 (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-Q001 (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-Q001 (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-Q001 (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-Q001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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-Q001 (HMO-POS D-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are available with no copay for a 1-month or 3-month supply at standard pharmacies, or a 3-month supply via standard mail order. This plan provides an affordable option for those utilizing preferred generic medications. For Tier 2 generic and Tier 3 preferred brand drugs, members are responsible for a 25% coinsurance on 1-month and 3-month supplies at standard pharmacies and mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs also require a 25% coinsurance for 1-month supplies at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan offers comprehensive coverage for core medical needs, featuring no copays for primary care, specialist visits, and outpatient services, though coinsurance up to 20% may apply. Inpatient hospital stays require a $2,230 copay for acute care and a $2,080 copay for psychiatric care, both with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. Additionally, skilled nursing facility stays and home health services are covered with no copays or coinsurance. For supplemental health, the plan provides routine dental, vision, and preventive services with no copays or coinsurance, which includes cleanings and a $200 annual eyewear allowance. Hearing services feature no copays for routine exams and covered hearing aids, though the exams are subject to a 20% coinsurance. Members also benefit from no copays on over-the-counter items and home infusion services, though medical equipment and Part B drugs may require up to 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP), with acute stays requiring a $2,230 copay per stay and no coinsurance, and psychiatric stays requiring a $2,080 copay per stay and no coinsurance. 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
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers outpatient services with no copay, though prior authorization is required and coinsurance ranges from no coinsurance up to 20%. This coverage includes outpatient hospital visits, ambulatory surgical center services, outpatient substance abuse treatment, and outpatient blood services.
Partial Hospitalization See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
UHC Dual Complete NY-Q001 (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 have a copay ranging from $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers primary care, specialist, and mental health services with no copay and 0% to 20% coinsurance, while occupational, physical, and speech therapies require no copay and 20% coinsurance. Telehealth and opioid treatments feature no copay and no coinsurance, routine podiatry is covered up to 4 annual visits with no copay and 20% coinsurance, and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP), offering no copay and no coinsurance for annual physicals, fitness benefits, and caregiver support, while digital rectal exams and post-welcome visit EKGs require a 20% coinsurance with no copay. Excluded sub-services include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, tobacco cessation counseling, enhanced disease management, telemonitoring, remote access, and counseling services.
Hearing Services See details
Hearing Services are partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP), offering one annual routine exam with no copay and 20% coinsurance, and OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are covered up to $1,500 every two years with no copay and no coinsurance, but fitting and evaluation exams, as well as inner, outer, and over-the-ear prescription devices, are not covered.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay or coinsurance for covered services, including one routine eye exam and up to $200 annually for eyewear like lenses, frames, and contacts. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers Medicare dental services with no copay and 20% coinsurance. Other preventive and comprehensive dental services, including cleanings, implants, and orthodontics, are covered with no copay and no coinsurance, with prior authorization required for comprehensive care.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment benefits under UHC Dual Complete NY-Q001 (HMO-POS D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, though manufacturer limitations apply, and prior authorization is required for these medical equipment services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with prior authorization, offering diagnostic radiological services with no copay and no coinsurance. Lab services require no copay but are subject to coinsurance, while diagnostic tests require both a copay and a 20% coinsurance. Outpatient X-rays and therapeutic radiological services require no copay but carry a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers some Cardiac Rehabilitation Services with no copay, but in practice, sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay and no coinsurance, as additional days beyond the standard Medicare-covered limit are not covered. Prior authorization is required, but the plan does not require a three-day prior inpatient hospital stay for admission.
Other Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
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