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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 2026, 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 4 out of 5 stars in 2026.
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 $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 $532.00 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-D002 (HMO-POS D-SNP) Medicare plan features an annual prescription drug deductible of $532. For Tier 1 preferred generic and Tier 2 generic drugs, there is no copay for one-month or three-month supplies filled at standard pharmacies or through standard mail order. This ensures that your essential generic medications remain highly affordable throughout the year. For higher-tier medications, your costs are determined by coinsurance rather than flat copays. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail-order fills. This consistent coinsurance rate helps you easily estimate out-of-pocket costs for brand-name and specialty prescriptions.
Additional Benefits
The UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan offers robust medical coverage, including inpatient hospital stays with a $2,075 copay per admission and no coinsurance. Most outpatient care, primary care visits, and specialist services feature no copay, though some treatments may require a coinsurance of up to 20%. Emergency room visits carry a $115 copay that is waived if you are admitted within 24 hours, while urgent care and telehealth services have low to no copays. This plan also provides valuable supplemental benefits, featuring no copay or coinsurance for routine vision exams, a $250 annual eyewear allowance, and up to $2,000 in annual dental care. Additionally, members receive hearing aid coverage up to $1,500 every two years with no copay, along with up to 24 routine one-way transportation trips per year. Other essential services like home health care, skilled nursing facility stays, and over-the-counter items are also covered with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance and a $2,075 copay per admission, requiring both prior authorization and referrals. While unlimited additional acute hospital days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers outpatient services with no copay, with coinsurance ranging from no coinsurance to 20% for outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services are also covered with no copay and 20% coinsurance, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Both prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under UHC Dual Complete TX-D002 (HMO-POS D-SNP) are covered, with ground and air ambulance services requiring a 20% coinsurance and no copay. Routine transportation is partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance.
Primary Care See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers primary care, specialist, psychiatric, and mental health services with no copay and 0% to 20% coinsurance. Physical, occupational, and speech therapy services are covered with no copay and 20% coinsurance, while chiropractic services are not covered in practice. Telehealth and opioid treatment programs are available with no copay and no coinsurance, and routine podiatry is covered for up to 4 visits per year with 20% coinsurance.
Preventive Services See details
Preventive services are covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and fitness benefits. While several options like health education and personal emergency response systems are not covered, other services such as digital rectal exams and EKGs require a 20% coinsurance and no copay.
Hearing Services See details
Hearing services are partially covered with no deductible by UHC Dual Complete TX-D002 (HMO-POS D-SNP), offering one routine hearing exam annually with no copay and a 20% coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are covered up to $1,500 every two years and OTC hearing aids are covered up to two devices every two years, both with no copay and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) provides partially covered vision services with no copay and no coinsurance for covered benefits, including one routine eye exam per year and a $250 annual allowance for contacts, lenses, and frames. Other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP), offering up to $2,000 in annual coverage with no copay and no coinsurance for preventive and most comprehensive dental care. While Medicare-covered dental services require no copay and a 20% coinsurance, implant services and orthodontics are not covered by the plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP) with no copay, though prior authorization and step therapy are required. Covered Medicare Part B chemotherapy, radiation, and other drugs require from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Medical Equipment See details
Medical equipment is covered under the UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan, with durable medical equipment (DME), prosthetics, and medical supplies requiring no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP) with prior authorization and referrals required. Outpatient diagnostic procedures and tests require a copay and 20% coinsurance, while lab services have no copay, diagnostic radiology has no copay or coinsurance, and therapeutic radiology and X-ray services carry a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered under the UHC Dual Complete TX-D002 (HMO-POS D-SNP) plan with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) covers Cardiac Rehabilitation Services with no copay, but some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance. Prior authorization and referrals are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete TX-D002 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization and referrals are required. This benefit allows for admission with less than a three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete TX-D002 (HMO-POS D-SNP) partially covers other services, providing over-the-counter (OTC) items and a meal benefit for chronic illnesses with no copay and no coinsurance. However, acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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