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UHC Dual Complete TX-Y1 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete TX-Y1 (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 TX-Y1 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Harris County. The overall rating for this plan is not yet available for 2026.
It's important to know that UHC Dual Complete TX-Y1 (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 TX-Y1 (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 TX-Y1 (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 TX-Y1 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 $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 TX-Y1 (HMO-POS D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are available with no copay for 1-month and 3-month supplies at standard pharmacies and standard mail order. For Tier 2 generic drugs, you will pay a 25% coinsurance for both 1-month and 3-month supplies. Tier 3 preferred brand drugs also require a 25% coinsurance for 1-month and 3-month fills through standard pharmacies and mail order. For higher-tier medications, including Tier 4 non-preferred drugs and Tier 5 specialty drugs, you will pay a 25% coinsurance for a 1-month supply. This straightforward cost-sharing structure helps you easily plan for your monthly medication expenses.
Additional Benefits
The UHC Dual Complete TX-Y1 (HMO-POS D-SNP) plan offers robust healthcare coverage with no copays for primary care visits, home health services, and skilled nursing facility stays. Many key supplemental benefits, such as routine dental care up to a $2,500 annual maximum and annual vision exams with a $200 eyewear allowance, are also provided with no copay. While most preventive care is covered at no cost, some outpatient services and medical equipment require no copay but carry a coinsurance of up to 20%. For inpatient hospital stays, members are responsible for a $1,720 copay per stay with no coinsurance, while emergency room visits require a $115 copay that is waived if admitted. Additional specialized benefits include over-the-counter items and up to 36 one-way transportation trips to approved locations with no copay. Diagnostic imaging, dialysis, and Medicare Part B drugs generally feature no copay but are subject to a coinsurance of up to 20%.
Inpatient Hospital See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) partially covers inpatient hospital services, requiring a $1,720 copay per stay and no coinsurance for both acute and psychiatric stays. While unlimited additional acute days are covered with no copay, non-Medicare-covered stays and hospital upgrades are not covered.
Outpatient Services See details
Outpatient services under UHC Dual Complete TX-Y1 (HMO-POS D-SNP) are covered with no copays, though coinsurance ranges from 0% to 20% depending on the specific service. This includes outpatient hospital, ambulatory surgical center, and substance abuse services, while outpatient blood services and observation services carry a 20% coinsurance with no deductible.
Partial Hospitalization See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete TX-Y1 (HMO-POS D-SNP), requiring a 20% coinsurance and no copay for ground and air ambulance services. Transportation benefits are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered by UHC Dual Complete TX-Y1 (HMO-POS D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) offers primary care, specialist, therapy, and mental health services with no copay and coinsurance ranging from 0% to 20%. Additional telehealth and opioid treatment services are covered with no copay and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by the UHC Dual Complete TX-Y1 (HMO-POS D-SNP) plan, with most services—including annual physical exams, fitness benefits, and kidney disease education—offered with no copay and no coinsurance. Medicare-covered digital rectal exams and post-welcome visit EKGs require a 20% coinsurance and no copay, while several supplemental services, such as health education, personal emergency response systems, and nutritional therapy, are not covered.
Hearing Services See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) offers partially covered hearing services, featuring routine hearing exams with no copay and a 20% coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to two devices every two years (with a $2,200 limit for prescription aids), but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) provides partially covered vision services with no copay, no coinsurance, and no deductible, though other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered. Covered benefits include one routine eye exam per year and up to $200 annually for eyewear, which includes contact lenses, one pair of eyeglass lenses, and one frame.
Dental Services See details
Dental services are partially covered by UHC Dual Complete TX-Y1 (HMO-POS D-SNP), offering most preventive and comprehensive services with no copay and no coinsurance up to a $2,500 annual maximum. Medicare-covered dental services have no copay and a 20% coinsurance, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin drugs also requiring a copay of $35.
Dialysis Services See details
Dialysis services are covered by UHC Dual Complete TX-Y1 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Both prior authorization and a referral are required for coverage.
Medical Equipment See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay from specified manufacturers, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Dual Complete TX-Y1 (HMO-POS D-SNP) with prior authorization, featuring no copay but applicable coinsurance for lab services and a copay with minimum 20% coinsurance for diagnostic tests. Radiological services require no copay, offering diagnostic radiology with no coinsurance and therapeutic radiology and outpatient X-rays with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete TX-Y1 (HMO-POS D-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization and a referral are required. A prior three-day inpatient hospital stay is not required for admission, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete TX-Y1 (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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