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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 2026, 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 4 out of 5 stars in 2026.
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 $0.40. 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 $615.00 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-S003 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for 3-month standard mail orders. This coverage ensures that your most common generic medications are highly affordable. For Tier 2 generic and Tier 3 preferred brand drugs, members pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and standard mail order services. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance for a 1-month supply at standard pharmacies and through standard mail order. These structured costs help you clearly understand what to expect for your brand-name and specialty medication expenses.
Additional Benefits
The UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring no copays for most primary care visits and outpatient services, though some care may require up to 20% coinsurance. Inpatient hospital stays require a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay with no coinsurance, while skilled nursing and home health services require no copays or coinsurance. Emergency room visits carry a $115 copay, which is waived if you are admitted within 24 hours. For everyday wellness, the plan provides routine dental and vision care with no copays or coinsurance, up to a $2,500 annual dental limit and a $200 eyewear limit. Members also benefit from no copays and no coinsurance on over-the-counter items, up to $2,200 every two years for hearing aids, and up to 36 one-way transportation trips per year. Other essential services, including durable medical equipment and dialysis, are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay. Unlimited additional acute days are available at no copay, but upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP) with no copay, and coinsurance ranging from no coinsurance up to 20% depending on the service. This coverage applies to outpatient hospital, ambulatory surgical center, substance abuse, and blood services, which require prior authorization and a referral.
Partial Hospitalization See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services. Transportation benefits are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) covers emergency services with a $115 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits under the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan feature no copays for most services, with coinsurance ranging from 0% to 20% for primary care, specialist, psychiatric, and mental health services. While telehealth and opioid treatments have no copays or coinsurance, therapy and podiatry services require a 20% coinsurance with no copay, and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP), with annual physical exams, fitness benefits, and kidney disease education offered with no copay and no coinsurance. While EKGs following a welcome visit require a 20% coinsurance and no copay, several services are not covered, including health education, personal emergency response systems, medical nutrition therapy, and alternative therapies.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP), featuring routine hearing exams with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Covered prescription and over-the-counter hearing aids have no copay and no coinsurance up to a $2,200 maximum limit every two years, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered under the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan, offering routine eye exams, contact lenses, eyeglass lenses, and frames with no copay and no coinsurance. While there is a $200 annual maximum benefit for covered eyewear, other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP), excluding implant services and orthodontics. Medicare-covered dental services feature no copay and a 20% coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $2,500 yearly limit.
Home Infusion bundled Services See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Part B chemotherapy, radiation, and other drugs require no copay and carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP) 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 by UHC Dual Complete TX-S003 (HMO-POS D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for most of these services.
Diagnostic and Radiological Services See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) covers diagnostic and radiological services, requiring prior authorization and referrals for all care. Diagnostic procedures require a copay and 20% coinsurance, lab services have no copay but require coinsurance, and diagnostic radiology has no copay or coinsurance, while therapeutic radiology and outpatient X-rays carry a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP) with no copay and no coinsurance. Both a referral and prior authorization are required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered with no copay under the UHC Dual Complete TX-S003 (HMO-POS D-SNP) plan; however, only some services are covered, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete TX-S003 (HMO-POS D-SNP) with no copay and no coinsurance, requiring both prior authorization and a referral. The plan allows for SNF admission with less than a three-day prior hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete TX-S003 (HMO-POS D-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated services are not covered under this plan.
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