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UHC Dual Complete TX-V01P (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-V01P (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-V01P (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete TX-V01P (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-V01P (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-V01P (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-V01P (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-V01P (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. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 $266.00 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 $4200.00 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:
Sign up for UHC Dual Complete TX-V01P (HMO-POS D-SNP)
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Drug Coverage
The UHC Dual Complete TX-V01P (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $266. You will enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs filled at standard pharmacies or through standard mail order. This includes no copay for both 1-month and 3-month supplies at standard pharmacies, as well as 3-month mail order supplies. For brand-name and specialty prescriptions, the plan requires a 25% coinsurance across Tiers 3, 4, and 5. This 25% coinsurance applies to standard pharmacy fills and standard mail order options, covering up to a 3-month supply for Tier 3 drugs and 1-month supplies for Tier 4 and Tier 5 drugs. These clear cost-sharing tiers make it easy to estimate your out-of-pocket expenses for more specialized medications.
Additional Benefits
The UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan offers comprehensive coverage with many key services featuring no copay and no coinsurance. Beneficiaries enjoy no copay for primary care visits, preventive services, annual routine eye exams, and routine hearing exams. Routine dental care is also covered with no copay up to a $1,500 annual limit, alongside select eyewear and over-the-counter items. For specialized medical needs, the plan provides access to specialists with copays ranging from $0 to $30 and no coinsurance. Inpatient hospital stays require a $420 copay per admission, while emergency room visits have a $150 copay, both with no coinsurance. Durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance, ensuring affordable management of chronic conditions.
Inpatient Hospital See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers inpatient acute and psychiatric stays with a $420 copay per admission and no coinsurance, though prior authorization is required. The benefit is partially covered because upgrades and non-Medicare-covered stays are not covered, and additional psychiatric days are not covered, while unlimited additional acute days are covered with no copay and no coinsurance.
Outpatient Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $420 for outpatient hospital services and a $420 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require no coinsurance and copays between $0 and $25.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP) with a $55 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers ground and air ambulance services with a $290.00 copay and no coinsurance, subject to prior authorization. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers emergency services with a $150 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay ranging from $0 to $65 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary Care benefits under UHC Dual Complete TX-V01P (HMO-POS D-SNP) feature no copay and no coinsurance for primary care provider visits, telehealth, and opioid treatment. Specialist visits require a $0 to $30 copay, therapy and podiatry services carry a $30 copay, and mental health sessions range from no copay to a $25 copay, all with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, and diabetes self-management. Additional preventive benefits are partially covered with no copay or coinsurance for fitness and in-home support, but sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP), offering annual routine hearing exams with no copay and no coinsurance, though fitting and evaluation services are not covered. Prescription hearing aids have a copay of $199.00 to $1,249.00 and OTC hearing aids have a copay of $199.00 to $829.00, both with no coinsurance, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) offers partially covered vision services with no coinsurance and no deductible, featuring one routine eye exam per year with no copay. Eyewear is also covered with no coinsurance and a $200 limit every two years, offering contact lenses and frames with no copay and lenses with a $0 to $153 copay, though other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) offers partially covered dental services, excluding implant and orthodontic services. Preventive and diagnostic care has no copay and no coinsurance up to a $1,500 annual limit, while Medicare-covered dental has no copay and 20% coinsurance, and covered comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP) with no copay and no coinsurance, subject to prior authorization. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive this care.
Medical Equipment See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies and therapeutic shoes or inserts are also covered with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers diagnostic and radiological services, with prior authorization required. Diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays have a $25 copay, and therapeutic radiology has a 20% coinsurance, while lab services and diagnostic radiology are covered with no copay and no coinsurance.
Home Health Services See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan, as all major sub-services—including intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete TX-V01P (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization and referrals are required, and while the plan does not cover additional days beyond the standard 100-day limit, it does allow admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered by UHC Dual Complete TX-V01P (HMO-POS D-SNP), featuring over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated services for dual-eligible SNPs are not covered under this benefit.
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