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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 2025, 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 3.5 out of 5 stars in 2025.
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 $43.50. 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 $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-Q001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2,000. If you qualify for the low-income subsidy, you will pay $43.50 for Part D. After your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan offers a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a $1990 copay per admission, and emergency services have a $110 copay, while many primary care and specialist services have coinsurance between 0-20%. This plan includes coverage for preventive, hearing, vision, and dental services, often with no copay. The plan also includes coverage for home health services, medical equipment, and other services like acupuncture and OTC items.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but require prior authorization. For Inpatient Hospital-Acute, you will have a copay of $1990 per admission or stay, and additional days 91-999 have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and all Inpatient Hospital Psychiatric additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient hospital services, including observation services, are covered with a coinsurance between 0% and 20%, and require prior authorization. Ambulatory Surgical Center (ASC) Services have a coinsurance between 0% and 20%, and Outpatient Substance Abuse Services have a coinsurance between 0% and 20% for individual sessions, and a 20% coinsurance for group sessions. Outpatient blood services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) covers primary care physician services with a 0-20% coinsurance, chiropractic services with 20% coinsurance (routine care) and no copay (routine care), occupational therapy services with 0-20% coinsurance and no copay, physician specialist services with 0-20% coinsurance, mental health specialty services with 0-20% coinsurance, podiatry services with 20% coinsurance (routine foot care) and no copay (Medicare-covered podiatry services), other health care professional services with 0-20% coinsurance, psychiatric services with 0-20% coinsurance, physical therapy and speech-language pathology services with 0-20% coinsurance and no copay, additional telehealth benefits with no copay, and opioid treatment program services with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services with a copay and/or coinsurance. Specific services like Health Education, In-Home Safety Assessment, and others are not covered.
Hearing Services See details
Hearing services include routine hearing exams with no copay and at most 20% coinsurance for routine hearing exams, though fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and contact lenses, eyeglass lenses, and eyeglass frames are covered with no copay, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, 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. Additionally, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics all have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a 20% coinsurance and requires authorization, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a coinsurance of at most 20%, and lab services with no copay. Diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services have a coinsurance of at most 20%.
Home Health Services See details
Home health services are covered by the UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not provide SNF services as a supplemental benefit under Part C. You will pay the Medicare-defined cost share for tier 1, and there is a copay.
Other Services See details
The UHC Dual Complete NY-Q001 (HMO-POS D-SNP) plan covers acupuncture with no copay, and up to 12 treatments per year. The plan also covers Over-the-Counter (OTC) Items with no copay, including Nicotine Replacement Therapy (NRT) and Naloxone, but does not cover all drugs on the CMS OTC list. Meal benefits are covered with no copay, and require prior authorization. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services and Private Duty Nursing Services are not covered.
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