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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 2025, 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, 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-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.
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 $590.00 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 $3900.00 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) plan has a $590 deductible for prescription drugs. After the deductible, the plan will cover your prescription drugs. If you qualify for the low-income subsidy, you will pay $0.00 for your prescriptions. Once your total drug costs reach $2000.00, you will enter the next coverage phase.
Additional Benefits
The UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $350 copay, while outpatient services have copays ranging from $0 to $350. Ambulance and transportation services are covered, and emergency services have a $140 copay. Preventive services, primary care, vision exams, and some dental services are covered with no copay. Hearing exams are covered, as are prescription hearing aids with a copay. Diagnostic and radiological services have varying copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization and a doctor referral. For Inpatient Hospital-Acute, you will pay a $350 copay per stay for Medicare-covered stays, and for days 91-999, there is no copay. Non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric has a $350 copay per stay for Medicare-covered stays, while additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $350, and observation services with a $350 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a copay between $0 and $25 for individual sessions, and a $15 copay for group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan. Ground and air ambulance services have a $290 copay, with no coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay and no coinsurance for up to 24 one-way trips per year via taxi or medical transport, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $65. Worldwide Emergency Services have a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, but the amount is not specified. There is no coinsurance for any of these services.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay, while Chiropractic Services have a $20 copay. Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, and Psychiatric Services have copays ranging from $0 to $25. Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include coverage for many services, including an annual physical exam with no copay, and additional preventive services, Kidney Disease Education Services, and other services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay. Some services, like Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered, with a copay of $199-$1249, depending on the hearing aid type, but hearing aids for inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay of $99-$829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay and include routine eye exams with no copay. Eyewear has no copay, but eyeglass lenses have a copay between $0 and $153, and contact lenses and eyeglass frames have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a $2,500 annual maximum. Medicare Dental Services have a 20% coinsurance, while Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Maxillofacial Prosthetics, and Oral and Maxillofacial Surgery have no copay. Prosthodontics, removable and Prosthodontics, fixed have a coinsurance between 0% and 50%. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization and a doctor referral, with a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. For Diagnostic Procedures/Tests, you will pay a copay of $50.00. Lab Services have no copay. Diagnostic Radiological Services have a copay that may be up to $225.00, and Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TX-V01P (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 not covered under the UHC Dual Complete TX-V01P (HMO-POS D-SNP) plan. Prior authorization and a doctor's referral are required for this service.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization and a doctor's referral. You will have no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
Other Services includes Over-the-Counter (OTC) items with no copay, while acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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