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UHC Dual Complete TX-D01P (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-D01P (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-D01P (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-D01P (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 Fort Bend, Harris, and Montgomery Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete TX-D01P (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-D01P (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-D01P (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-D01P (HMO-POS D-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 $495.00 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 TX-D01P (HMO-POS D-SNP) plan has a $495 deductible for prescription drugs. After meeting the deductible, you will pay 25% coinsurance for many drugs, dependent on the tier and pharmacy used. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The UHC Dual Complete TX-D01P (HMO-POS D-SNP) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays and coinsurance. Emergency, urgent, and worldwide emergency services are covered, with some services having a copay. The plan also covers primary care, preventive, hearing, vision, and dental services, with specific copays or coinsurance for each. Additional benefits include home health services, durable medical equipment, and dialysis services, with associated costs. Transportation to health-related locations is covered, and the plan offers over-the-counter item coverage. This plan also covers partial hospitalization, and home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $2,000 copay per admission or stay, and for Additional Days for Inpatient Hospital-Acute, there is no copay for days 91-999.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a coinsurance between 0% and 20%, observation services have a 20% coinsurance, and ambulatory surgical center services have a coinsurance between 0% and 20%. Outpatient substance abuse services have a coinsurance between 0% and 20% for individual sessions and a 20% coinsurance for group sessions. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete TX-D01P (HMO-POS D-SNP) plan, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, up to 48 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services has a $110 copay and 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 have no copay and no coinsurance.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with 0% to 20% coinsurance, Chiropractic Services with 20% coinsurance (prior authorization required, but routine care is not covered), Occupational Therapy Services with 0% to 20% coinsurance (prior authorization and referral required), and Physician Specialist Services with 0% to 20% coinsurance (prior authorization and referral required). Mental Health Specialty Services include individual sessions with 0% to 20% coinsurance, and group sessions with 20% coinsurance (prior authorization required). Podiatry Services include routine foot care with 20% coinsurance (up to 4 visits per year), while Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include no copay for an annual physical exam, and additional preventive services may have a copay. Kidney disease education services are covered with no copay, and other preventive services have varying costs with some services incurring a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with at most 20% coinsurance, and routine hearing exams are covered with no copay for 1 visit every year. Prescription hearing aids are covered and may have a copay, and OTC hearing aids are covered with no copay for 2 hearing aids every year. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered with no copay for one visit every year. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames, all with no copay; however, eyeglass lenses and frames are limited to one per year, and there is a combined maximum of $200 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance. Other Dental Services have a $1,500 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventative dental services have no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery have no copay. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor referral. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services, are covered. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, and Lab Services have no copay. Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TX-D01P (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 not in practice. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor referral. The plan does not cover additional days beyond Medicare-covered SNF stays, nor does it cover non-Medicare-covered SNF stays.
Other Services See details
Other Services under the UHC Dual Complete TX-D01P (HMO-POS D-SNP) plan covers over-the-counter items with no copay. Acupuncture, meal benefits, dual eligible SNPs with highly integrated services, and other services including EPSDT, private duty nursing, case management, and more are not covered.
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