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UHC Dual Complete MD-S001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete MD-S001 (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 MD-S001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete MD-S001 (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 Montgomery County. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete MD-S001 (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 MD-S001 (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 MD-S001 (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 MD-S001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.80. 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 $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 MD-S001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $37.70 for Part D. During the initial coverage phase, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete MD-S001 (HMO-POS D-SNP) plan offers comprehensive coverage with a variety of benefits. Inpatient hospital stays have a $1755 copay per admission, while emergency services have a $110 copay, and outpatient services have a coinsurance between 0% and 20%. The plan also includes additional benefits such as hearing, vision, and dental services with varying copays and coinsurance, including routine hearing exams, eye exams, and many dental services with no copay. This plan provides coverage for a wide array of services, including ambulance and transportation services, with transportation services to plan-approved health-related locations covered for 24 one-way trips per year. Diagnostic and radiological services, home health services, and medical equipment are covered with varying coinsurance. Additionally, the plan includes coverage for OTC items, and other services, while some services like acupuncture and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $1755 per admission or stay for Medicare-covered stays. Additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a coinsurance between 0% and 20%, observation services with 20% coinsurance, ambulatory surgical center (ASC) services with a coinsurance between 0% and 20%, individual sessions for outpatient substance abuse with a coinsurance between 0% and 20%, group sessions for outpatient substance abuse with 20% coinsurance, and outpatient blood services with 20% coinsurance. This plan also waives the deductible for three pints of blood.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by UHC Dual Complete MD-S001 (HMO-POS D-SNP), including ground and air ambulance services with a 20% coinsurance, and transportation services with no copay. Transportation services to any health-related location are not covered, but transportation services to plan-approved health-related locations are covered for 24 one-way trips every year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete MD-S001 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $45 with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with a coinsurance between 0% and 20%, while Chiropractic Services are covered with a 20% coinsurance. Occupational Therapy Services are covered with a coinsurance between 0% and 20%, and Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional services with a copay. Some services, such as Health Education, In-Home Safety Assessment, and Personal Emergency Response System (PERS), are not covered. Other preventive services, such as Digital Rectal Exams and EKG following Welcome Visit, have a 20% coinsurance.
Hearing Services See details
Hearing services include routine hearing exams with no copay and a 20% coinsurance, and prescription hearing aids with no copay, and a maximum benefit of $1500 per year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams and eyewear, with routine eye exams and contact lenses covered with no copay. Eyeglass lenses and frames are covered with no copay, and you are limited to one pair of each per year. However, 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 and a maximum plan benefit of $1,500 per year for other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. However, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, and Prosthetics/Medical Supplies with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment is covered, with Medicare-covered Diabetic Supplies having no copay, and Medicare-covered Diabetic Therapeutic Shoes or Inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the UHC Dual Complete MD-S001 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete MD-S001 (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 Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered stays or non-Medicare-covered stays. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
The UHC Dual Complete MD-S001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with no copay. However, acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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