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UHC Dual Complete WI-V001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WI-V001 (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 WI-V001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WI-V001 (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 State of Wisconsin. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete WI-V001 (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 WI-V001 (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 WI-V001 (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 WI-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $17.30. 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 $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 $4900.00 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 prescription drug coverage for the UHC Dual Complete WI-V001 (HMO-POS D-SNP) plan includes an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as for a 3-month standard mail-order supply. For Tier 2 generic and Tier 3 preferred brand drugs, the plan requires a 25% coinsurance for both standard pharmacy and standard mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty tier drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail-order.
Additional Benefits
The UHC Dual Complete WI-V001 (HMO-POS D-SNP) offers robust coverage with many essential services featuring no copay and no coinsurance, including primary care, preventive care, and home health services. For inpatient hospital stays, members pay a $455 daily copay for the first several days and no copay for subsequent days, while specialist visits feature low copays with no coinsurance. Emergency care carries a $130 copay, which is waived if you are admitted, and urgent care ranges from no copay up to $50. This plan also provides supplemental benefits, including dental, vision, and hearing coverage with no copay for routine exams, alongside allowances for eyewear and hearing aids. While many services require no coinsurance, a 20% coinsurance applies to dialysis, durable medical equipment, and certain Medicare Part B drugs. Additionally, members can access covered over-the-counter items and up to 24 one-way transportation trips per year with no copay.
Inpatient Hospital See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $455 copay for days 1 to 6 for acute stays and days 1 to 5 for psychiatric stays, with no copay for subsequent days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring copays of $0 to $455 for hospital services and a $455 daily copay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse services carry a $0 to $25 copay with no coinsurance.
Partial Hospitalization See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete WI-V001 (HMO-POS D-SNP) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care features a copay ranging from no copay to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are offered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) provides primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, physical and occupational therapy, and mental health services have no coinsurance and copays ranging from $0 to $45, though only some chiropractic services are covered as routine and other chiropractic care are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete WI-V001 (HMO-POS D-SNP) with no copay and no coinsurance for covered care, including annual physical exams, fitness benefits, and glaucoma screenings. However, several sub-services are not covered under this plan, including health education, personal emergency response systems (PERS), medical nutrition therapy, alternative therapies, and therapeutic massage.
Hearing Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) partially covers hearing services, offering one annual routine exam with no copay and no coinsurance, while fitting and evaluation exams are not covered. Up to two prescription hearing aids (copays of $199.00 to $1,249.00) and two OTC hearing aids (copays of $199.00 to $829.00) are covered per year with no coinsurance, though inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete WI-V001 (HMO-POS D-SNP) with no copay and no coinsurance, offering one routine eye exam per year and a $200 annual limit for eyewear such as contact lenses, eyeglass lenses, and frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers preventive and diagnostic dental services with no copay and no coinsurance, up to a $1,000 annual maximum. Medicare-covered dental services have no copay and 20% coinsurance, while comprehensive dental services are partially covered with no copay and 50% coinsurance, excluding implant services and orthodontics which are not covered.
Home Infusion bundled Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the UHC Dual Complete WI-V001 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic supplies are covered with no copay under manufacturer limits, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete WI-V001 (HMO-POS D-SNP), with prior authorization required. Diagnostic tests require a $50 copay and no coinsurance, lab services and diagnostic radiological services have no copay, outpatient x-rays require a $25 copay, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete WI-V001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete WI-V001 (HMO-POS D-SNP) plan. This includes no coverage for standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no preceding three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete WI-V001 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture, highly integrated services, and other supplemental services are not covered.
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