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UHC Dual Complete TX-S003 (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-S003 (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-S003 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-S003 (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-S003 (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-S003 (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-S003 (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-S003 (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 $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-S003 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the cost-sharing for your prescriptions. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). If you have LIS, you will pay $18.30 per month for your Part D premium. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan offers a variety of benefits with varying cost-sharing. For inpatient hospital stays, you'll pay a $1,725 copay per admission. Outpatient services, primary care, preventive services, and many others are covered, often with no copay or a coinsurance of up to 20%. The plan includes coverage for emergency services, hearing, vision, and dental services, often with no copay. Other benefits include ambulance, transportation, and home health services, also with no copay in most cases. You may need to get prior authorization for some services.
Inpatient Hospital See details
Inpatient Hospital benefits for UHC Dual Complete TX-S003 (HMO-POS D-SNP) include Inpatient Hospital-Acute, with a copay of $1,725 per admission or stay, and Additional Days for Inpatient Hospital-Acute with no copay for days 91-999; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric also has a copay of $1,725 per admission or stay, but Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 0% - 20% coinsurance, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a coinsurance between 0% and 20%, Individual Sessions for Outpatient Substance Abuse with a coinsurance between 0% and 20%, Group Sessions for Outpatient Substance Abuse with a 20% coinsurance, and Outpatient Blood Services with a 20% coinsurance. A prior authorization is required for all of these services.
Partial Hospitalization See details
Partial Hospitalization is covered under the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location has no copay. 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-S003 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay with 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
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan covers primary care physician services with a coinsurance between 0% and 20%, chiropractic services with a 20% coinsurance, and occupational therapy services with a coinsurance between 0% and 20%. The plan also covers routine chiropractic care with no copay, and additional telehealth benefits with no copay.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Additional preventive services include fitness benefits and home and bathroom safety devices with no copay, and also covers Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas with no copay. Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams with no copay and at most 20% coinsurance, along with prescription hearing aids (all types) with no copay, and OTC hearing aids with no copay. Fitting/evaluation for hearing aids, as well as prescription hearing aids - inner ear, outer ear, and over the ear, are not covered.
Vision Services See details
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and contact lenses have no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, with no copay for most services. Medicare Dental Services are covered with 20% coinsurance. Orthodontic and Implant Services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. Insulin has a $35 copay, and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of up to 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered for SNF, and also does not cover non-Medicare-covered stays for SNF.
Other Services See details
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan covers acupuncture with no copay, but is limited to 6 treatments per year. Over-the-counter (OTC) items are covered with no copay, including nicotine replacement therapy and naloxone, but it does not cover all drugs on the CMS OTC list. Other services such as meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and many others are not covered.
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