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UHC Dual Complete WI-D3 (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-D3 (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-D3 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WI-D3 (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 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-D3 (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-D3 (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-D3 (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-D3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.10. 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 WI-D3 (HMO-POS D-SNP) Medicare plan has an annual prescription drug deductible of $615. Tier 1 preferred generic drugs are covered with no copay for 1-month and 3-month supplies at standard pharmacies, as well as 3-month mail-order supplies. For Tier 2 generic drugs, you will pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and 3-month mail-order fills. Higher-tier medications under this plan utilize a consistent percentage-based cost-sharing system. Tier 3 preferred brand drugs require a 25% coinsurance for 1-month and 3-month supplies through standard pharmacies or mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for a 1-month supply at standard pharmacies and mail order.
Additional Benefits
The UHC Dual Complete WI-D3 (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring no copays for primary care visits, specialist consultations, and home health services, though some services may carry a 0% to 20% coinsurance. Inpatient hospital stays require a $1,920 copay per admission with no coinsurance, while emergency room visits have a $115 copay that is waived if you are admitted. Outpatient services, diagnostic lab tests, and skilled nursing facility care are also available with no copays, helping to keep out-of-pocket costs predictable. For supplemental care, this plan provides robust dental, vision, and hearing benefits, including no copays or coinsurance for routine vision exams, eyewear up to a $250 limit, and preventive dental care up to a $2,500 annual limit. Members also benefit from no copays on routine hearing exams, hearing aids, and up to 24 one-way transportation trips per year to approved health locations. Additionally, everyday essentials like over-the-counter items and chronic illness meals are covered with no copay and no coinsurance.
Inpatient Hospital See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,920 copayment per admission and no coinsurance, subject to prior authorization. This benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered, though unlimited additional acute care days are available with no copayment.
Outpatient Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers outpatient services with no copay, with coinsurance ranging from 0% to 20% depending on the service. Prior authorization is required for outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP) 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 WI-D3 (HMO-POS D-SNP) covers ambulance services with a 20% coinsurance and no copay for both ground and air transport. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay 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 WI-D3 (HMO-POS D-SNP) provides primary care and specialist visits with no copay and 0% to 20% coinsurance, while physical, occupational, and speech therapies require no copay and 20% coinsurance. Additionally, telehealth and opioid treatments are covered with no copay and no coinsurance, but some chiropractic services are covered while routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP), with annual physicals, kidney disease education, fitness, and in-home support offered with no copay and no coinsurance. Digital rectal exams and EKGs require a 20% coinsurance, whereas health education, safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, massage, adult day health, nutritional benefits, palliative care, smoking counseling, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP), featuring annual routine exams with no copay and 20% coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (excluding inner ear, outer ear, and over the ear models) and OTC hearing aids are covered with no copay and no coinsurance, subject to plan maximums and quantity limits.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP), offering one routine eye exam and eyewear with no copays, no coinsurance, and no deductible. Eyewear coverage includes a $250 annual maximum for contact lenses, eyeglass lenses, and eyeglass frames, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP), offering no copay and no coinsurance for most preventive and comprehensive care up to a $2,500 annual limit, though Medicare-covered dental services require a 20% coinsurance and no copay. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, although prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin specifically requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WI-D3 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are also covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and diagnostic radiological services with no copay or coinsurance. Diagnostic procedures require both a copay and 20% coinsurance, while therapeutic radiology and outpatient X-rays carry a 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay, a 20% coinsurance, and prior authorization requirements. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by UHC Dual Complete WI-D3 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. The plan allows for SNF admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete WI-D3 (HMO-POS D-SNP) provides partially covered other services, featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture, highly integrated services, and other miscellaneous services under this category are not covered.
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