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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Unitedhealthcare of New York, Inc. available for the 2026 plan year 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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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:
Sign up for UHC Dual Complete NY-Q001 (HMO-POS D-SNP)
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Drug Coverage
The UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs, whether filled as a 1-month or 3-month supply at a standard pharmacy, or as a 3-month supply via standard mail order. For Tier 2 generic and Tier 3 preferred brand drugs, the plan requires a 25% coinsurance for both 1-month and 3-month supplies at standard pharmacies or via standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty medications also carry 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) offers robust medical coverage, featuring inpatient hospital stays with a $2,230 copay and no coinsurance, while outpatient services and primary care visits require no copay and coinsurance up to 20%. Emergency care is available with a $115 copay, which is waived upon hospital admission, and urgent care ranges from no copay to a $40 copay. Routine dental, vision, and home health services are covered with no copays and no coinsurance, including a $200 annual eyewear allowance and coverage for hearing aids. Additionally, dialysis, durable medical equipment, and diagnostic services generally require no copay and a 20% coinsurance, while members can also access over-the-counter items and meal benefits with no copay.
Inpatient Hospital See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers inpatient acute hospital stays with a $2,230 copay per admission and psychiatric stays with a $2,080 copay per admission, both featuring no coinsurance. Prior authorization is required, and certain services like upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers outpatient services with no copays, though coinsurance ranges from no coinsurance to 20% depending on the service. Prior authorization is required for these benefits, which include outpatient hospital, ambulatory surgical, outpatient substance abuse, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these covered 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. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations is 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 require 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
Primary care services are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay and 0% to 20% coinsurance, which also applies to specialists, outpatient therapies, and mental health services. Telehealth and opioid treatment programs are covered with no copay and no coinsurance, though chiropractic services are only partially covered as routine and other chiropractic care 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, kidney disease education, and supplemental benefits like fitness and weight management, while digital rectal exams and EKGs require a 20% coinsurance and no copay. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation counseling, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services offered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) are partially covered, including one annual routine hearing exam with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (up to $1,500 every two years) and up to two OTC hearing aids every two years are covered with no copay and no coinsurance, though inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services under UHC Dual Complete NY-Q001 (HMO-POS D-SNP) are partially covered with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam and a $200 annual allowance for contact lenses, eyeglass lenses, or frames, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete NY-Q001 (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, exams, implants, and orthodontics, are covered with no copay and no coinsurance, though prior authorization is required for most comprehensive treatments.
Home Infusion bundled Services See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and radiation, have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
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 access these covered services.
Medical Equipment See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and diabetic therapeutic shoes or inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with prior authorization required. Diagnostic radiological services feature no copay and no coinsurance, while lab services have no copay, and diagnostic procedures, therapeutic radiological services, and outpatient X-rays require a minimum 20% coinsurance (with diagnostic procedures also requiring a copay).
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
Cardiac Rehabilitation Services are covered under UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay and prior authorization, meaning some services are covered. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP) with no copay or coinsurance, although prior authorization is required. The plan does not require a three-day prior hospital stay for admission, but additional days beyond those covered by Medicare are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete NY-Q001 (HMO-POS D-SNP), which offers over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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