A non-government entity
UHC Dual Complete TX-V001 (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-V001 (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-V001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-V001 (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 Select Counties in Texas. 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-V001 (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-V001 (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-V001 (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-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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 $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 $4900.00 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-V001 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan has a deductible of $590.00. If you qualify for the low-income subsidy, your monthly premium for Part D is $18.30. During the initial coverage phase, you will pay the costs for your drugs until your total drug costs reach $2000.00. Once you reach $2000.00 in out-of-pocket drug costs, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs.
Additional Benefits
The UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan offers a wide range of benefits with varying cost-sharing. Hospital stays have a copay, while outpatient services have copays that vary based on the service. Ambulance services have a copay, and transportation services are available with no copay. This plan includes no copay for primary care, preventive services, hearing exams, eye exams, and many dental services. You will also find no copay for home health services, and OTC items. However, some services, such as specialist visits, have copays, and some services have coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-6, and no copay for days 7-90, while additional days 91-999 have no copay; Non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric services have a $350 copay for days 1-6, and no copay for days 7-90; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $350, observation services have a $350 copay, ASC services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including all ambulance services, with a $290 copay for ground and air ambulance services, and transportation services with no copay. Transportation services to any health-related location are limited to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services has a $125 copay, Urgently Needed Services has a copay between $0 and $55, and Worldwide Emergency, Urgent, and Transportation services have no copay.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay. Occupational Therapy Services are covered with a copay between $0 and $35. Physician Specialist Services are covered with a copay between $0 and $35. Mental Health Specialty Services, Individual Sessions have a copay between $0 and $25, and Group Sessions have a $15 copay. Podiatry Services have a $35 copay. Other Health Care Professional services have a copay between $0 and $35. Psychiatric Services, Individual Sessions have a copay between $0 and $25, and Group Sessions have a $15 copay. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $35. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, along with an annual physical exam with no copay. Additional services like Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. However, 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. Prescription hearing aids are partially covered, with copays ranging from $199 to $1249, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision Services includes coverage for eye exams and eyewear. Eye exams have no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames. Contact lenses and eyeglass frames have no copay, while eyeglass lenses have a copay between $0 and $153. Eyeglass frames are limited to one every two years with a combined maximum benefit of $200 for all eyewear every two years, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan covers dental services, including exams, x-rays, cleanings, fluoride treatments, and other preventive and diagnostic services with no copay, and some with a 20% coinsurance. Restorative, endodontics, periodontics, prosthodontics, oral surgery, and maxillofacial prosthetics services are covered with no copay, but some services have a coinsurance of up to 50%; however, implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan, and require prior authorization. The plan has a $35 copay for Medicare Part B insulin drugs, and a coinsurance between 0% and 20% for Medicare Part B chemotherapy/radiation drugs and other Medicare Part B drugs.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered by the UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance, while Diabetic Supplies have no copay and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $45 copay for diagnostic procedures, tests, and lab services. Lab services have no copay, while diagnostic radiological services have a maximum copay of $250 and therapeutic radiological services have 20% coinsurance. Outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but there is no information about the cost sharing for this benefit. However, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization and a doctor's referral required. You will have no copay for days 1-20, and a $203 copay per day for days 21-100.
Other Services See details
Other Services for the UHC Dual Complete TX-V001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with no copay. However, 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved