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UHC Dual Complete TX-D002 (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-D002 (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-D002 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-D002 (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-D002 (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-D002 (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-D002 (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-D002 (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-D002 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $18.30.
Additional Benefits
The UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan offers comprehensive coverage, including inpatient hospital stays with a $2000 copay per admission or stay, outpatient services with varying coinsurance, and partial hospitalization with a $55 copay. Emergency, urgent, and worldwide emergency services are covered, with the emergency services having a $110 copay. The plan also includes primary care, preventive, hearing, vision, and dental services, often with no copays or coinsurance. Additional benefits include transportation services with no copay, and ambulance services with a 20% coinsurance. Home health services, home infusion, and skilled nursing facilities are covered, with no copay. The plan also offers acupuncture, over-the-counter items, and a meal benefit for chronic illness, all with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, the copay is $2000 per admission or stay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a coinsurance between 0% and 20%, observation services with a 20% coinsurance, and ambulatory surgical center services with a coinsurance between 0% and 20%. The plan also covers outpatient substance abuse services, including individual sessions with a coinsurance between 0% and 20%, and group sessions with a 20% coinsurance, as well as outpatient blood services with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
The UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan covers ambulance services with a 20% coinsurance for both ground and air ambulance services, and transportation services with no copay. Transportation services to any health-related location are not covered, but the plan does cover 48 one-way trips per year to plan-approved health-related locations via taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, Urgently Needed Services have a copay between $0 and $45 with no coinsurance, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
Primary Care Physician Services are covered with a coinsurance of 0% to 20%. Chiropractic Services are covered with a 20% coinsurance, and routine care has no copay. Occupational Therapy Services are covered, with a coinsurance between 0% and 20%. Physician Specialist Services are covered with a coinsurance of 0% to 20%, and Mental Health Specialty Services are covered with a coinsurance that varies based on the service type. Podiatry Services are covered, with routine foot care having a 20% coinsurance, and Medicare-covered services having no copay. Other Health Care Professional services are covered with a coinsurance between 0% and 20%, and Psychiatric Services are covered with a coinsurance that varies based on the service type. Physical Therapy and Speech-Language Pathology Services are covered with a coinsurance of 0% to 20%. Additional Telehealth Benefits are covered with no copay, and Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
Preventive Services are covered, including an annual physical exam with no copay. Other services include Fitness Benefits, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, and other preventive services, some of which may have a copay or coinsurance.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered with no copay, and OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams, routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames have no copay, while eyeglasses (lenses and frames) and upgrades are not covered. Eyewear has a combined maximum plan benefit of $250 per year.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable, fixed), maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, while implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan, but require prior authorization. You will pay a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance. Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services and Outpatient X-Ray Services also have a coinsurance of at most 20%. Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TX-D002 (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 covered, but the specific services "Cardiac Rehabilitation Services", "Intensive Cardiac Rehabilitation Services", "Pulmonary Rehabilitation Services", and "SET for PAD Services" are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered for SNF or non-Medicare-covered stays for SNF.
Other Services See details
The UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan covers acupuncture with no copay, up to 6 treatments per year. Over-the-counter items are covered with no copay, including nicotine replacement therapy and Naloxone, but does not cover all drugs on the CMS OTC list. The plan also offers a meal benefit with no copay for chronic illness. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services, are not covered.
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