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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 2026, 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 and Montgomery Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
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 $149.00 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-D01P (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $149. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for one-month or three-month supplies at standard pharmacies and standard mail order. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you are responsible for a 25% coinsurance. This 25% coinsurance cost sharing applies to standard pharmacy fills as well as standard mail order services. This direct cost structure helps you easily estimate your out-of-pocket prescription expenses.
Additional Benefits
The UHC Dual Complete TX-D01P (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring a $1,960 copay per stay and no coinsurance for inpatient hospital admissions. Most outpatient services, primary care visits, and specialist consultations require no copay, though you may pay up to 20% coinsurance depending on the service. Emergency room visits carry a $115 copay, which is waived if you are admitted within 24 hours, while urgent care is available with low to no copays. For everyday wellness, the plan provides routine dental, vision, and hearing benefits with no copays, featuring generous annual limits such as $1,500 for dental care and $200 for eyewear. Home health services, skilled nursing facility care, and over-the-counter items are also fully covered with no copay and no coinsurance. Additionally, patients can access up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers inpatient hospital services with a $1,960 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Unlimited additional acute care days are covered with no copay, but non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers outpatient services with no copay, including outpatient hospital visits, ambulatory surgical center services, outpatient substance abuse treatment, and blood services. Depending on the specific service, patients will pay between no coinsurance and 20% coinsurance, with no deductible required for blood services.
Partial Hospitalization See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services. Transportation services are covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, though the copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers primary care, specialist, mental health, and psychiatric services with no copay and 0% to 20% coinsurance. Physical, occupational, and speech therapies, as well as routine podiatry, are covered with no copay and 20% coinsurance, while telehealth and opioid treatments feature no copay and no coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers preventive services, including annual physicals and kidney disease education with no copay and no coinsurance, while digital rectal exams and EKGs require a 20% coinsurance and no copay. Additional preventive benefits are partially covered, excluding health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP), offering one routine hearing exam annually with no copay and a 20% coinsurance, while fitting and evaluation services are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to two aids every two years with a $1,500 limit for prescription aids, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP) with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and up to $200 annually for contact lenses, eyeglass lenses, and frames, while other eye exams, upgrades, and bundled eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP), excluding implant services and orthodontics. Medicare-covered dental services have no copay and a 20% coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $1,500 annual maximum.
Home Infusion bundled Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other infusion drugs require no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is covered under the UHC Dual Complete TX-D01P (HMO-POS D-SNP) plan with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP) with prior authorization. Diagnostic procedures and tests require a copay and a minimum 20% coinsurance, while lab services have no copay but require coinsurance. Diagnostic radiological services feature no copay and no coinsurance, while therapeutic radiology and outpatient X-rays have no copay and a minimum 20% coinsurance.
Home Health Services See details
UHC Dual Complete TX-D01P (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance. Access to these covered services requires both a referral and prior authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under UHC Dual Complete TX-D01P (HMO-POS D-SNP) are covered with no copay, but some services are not covered in practice. Specifically, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP) with no copay and no coinsurance, requiring both a referral and prior authorization. While a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Dual Complete TX-D01P (HMO-POS D-SNP), which provides 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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