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UHC Complete Care OR-5 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care OR-5 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care OR-5 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care OR-5 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Oregon. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care OR-5 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care OR-5 (HMO-POS C-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 Complete Care OR-5 (HMO-POS C-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 Complete Care OR-5 (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $355.00 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 $5500.00 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 Complete Care OR-5 (HMO-POS C-SNP) prescription drug plan has an annual deductible of $355. Tier 1 preferred generic drugs feature no copay for 1-month and 3-month supplies at standard pharmacies and through mail order. Tier 2 generic drugs have a $5 copay for a 1-month supply at standard pharmacies, but you can save with no copay for a 3-month supply through preferred mail order. For brand name and specialty medications, costs are based on coinsurance. Tier 3 preferred brand drugs require a 21% coinsurance, while Tier 4 non-preferred drugs have a 46% coinsurance. Tier 5 specialty drugs carry a 29% coinsurance for a 1-month supply across standard pharmacies and mail order services.
Additional Benefits
The UHC Complete Care OR-5 (HMO-POS C-SNP) plan offers comprehensive coverage with no copays or coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $455 for the first five days and no copay for subsequent days, while emergency room visits carry a $130 copay. Outpatient hospital services and specialist visits are highly affordable, featuring no coinsurance and low-to-no copays. Routine dental, vision, and hearing exams are available with no copays or coinsurance, though prescription hearing aids and eyeglass lenses require copays. Durable medical equipment and dialysis services are covered with no copays and a 20% coinsurance, while diabetic supplies feature no coinsurance. Additionally, members can access over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
UHC Complete Care OR-5 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a $455 copay per day for days 1 through 5 and no copay for days 6 and beyond. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Complete Care OR-5 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay between $0 and $455, while outpatient substance abuse sessions have a copay of $0 to $25, all with no coinsurance.
Partial Hospitalization See details
UHC Complete Care OR-5 (HMO-POS C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under the UHC Complete Care OR-5 (HMO-POS C-SNP) plan include Medicare-covered ground and air ambulance services for a $290 copay per service and no coinsurance, which require prior authorization. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
UHC Complete Care OR-5 (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $0 to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary care services under UHC Complete Care OR-5 (HMO-POS C-SNP) are covered with no copay and no coinsurance for primary care provider visits and telehealth. Specialists, mental health services, and physical, occupational, and speech therapies require copays ranging from $0 to $40 with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no copay and no coinsurance for covered options like annual physicals, kidney disease education, fitness benefits, and home safety devices. However, several additional services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and in-home support services.
Hearing Services See details
UHC Complete Care OR-5 (HMO-POS C-SNP) provides partially covered hearing services with no deductible, including one routine hearing exam annually with no copay and no coinsurance. Up to two prescription hearing aids per year are covered with a $199 to $1,249 copay and no coinsurance, and up to two OTC hearing aids are covered with a $199 to $829 copay and no coinsurance. Fitting and evaluation exams, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by UHC Complete Care OR-5 (HMO-POS C-SNP), offering no copay and no coinsurance for annual routine eye exams, contact lenses, and eyeglass frames, up to a $150 combined limit every two years. Covered eyeglass lenses require a copay of $0 to $153 with no coinsurance, while other eye exam services, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under UHC Complete Care OR-5 (HMO-POS C-SNP), which offers Medicare-covered dental care with no copay and 20% coinsurance, and preventive services like exams and cleanings with no copay and no coinsurance. Comprehensive dental benefits, including restorative care, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance, while Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no copays across all categories, though prior authorization is required. Under this plan, diabetic supplies and therapeutic shoes feature no coinsurance, while durable medical equipment, prosthetics, and medical supplies require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Complete Care OR-5 (HMO-POS C-SNP), with prior authorization required. Lab services feature no copay or coinsurance, diagnostic tests cost a $50 copay with no coinsurance, diagnostic radiology starts at no copay, outpatient X-rays require a $25 copay with coinsurance, and therapeutic radiology has a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under UHC Complete Care OR-5 (HMO-POS C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, the plan does not cover sub-services including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Complete Care OR-5 (HMO-POS C-SNP) with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. Patients will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered period are not covered.
Other Services See details
Other services are partially covered under the UHC Complete Care OR-5 (HMO-POS C-SNP), which provides over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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