Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete TX-Q3 (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-Q3 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Unitedhealthcare Community Plan of Texas, L.l.c. available for the 2026 plan year to people living in Harris County. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete TX-Q3 (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-Q3 (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.
Below are a few key facts and commonly-asked questions about UHC Dual Complete TX-Q3 (HMO-POS D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For UHC Dual Complete TX-Q3 (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 $0.20. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
This plan has a $503.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
The UHC Dual Complete TX-Q3 (HMO-POS D-SNP) prescription drug plan has an annual drug deductible of $503. Fortunately, members enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs filled at standard pharmacies or through standard mail order. This makes essential generic medications highly affordable for policyholders. For higher-tier medications, including Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, members will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy fills as well as standard mail order options. Knowing these copay and coinsurance details helps you accurately budget for your monthly prescription expenses.
The UHC Dual Complete TX-Q3 (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring no copays for primary care, telehealth, and preventative services, though some specialist and outpatient services require up to 20% coinsurance. Inpatient hospital stays require a copay of $2,200 for acute care and $2,080 for psychiatric care, but feature no coinsurance. Additionally, home health care and skilled nursing facilities are covered with no copayments, while emergency room visits require a $115 copay that is waived upon admission. This plan also includes valuable supplemental benefits, such as dental and vision coverage with no copays, including up to $1,500 annually for dental care and a $250 annual allowance for eyewear. Members also benefit from hearing coverage with no copay for routine exams and up to $1,500 every two years for prescription hearing aids. Finally, the plan provides up to 24 free one-way transportation trips per year and select over-the-counter items with no copay or coinsurance.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) provides partially covered inpatient hospital services with no coinsurance, requiring a $2,200 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Unlimited additional acute care days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers outpatient services with no copays, featuring no coinsurance to 20% coinsurance for outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services and observation services are also covered with no copay and 20% coinsurance.
Partial hospitalization is covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
UHC Dual Complete TX-Q3 (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 require a copay of no copay to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers primary care, specialist, psychiatric, and therapy services with no copay and 0% to 20% coinsurance, while telehealth and opioid treatment have no copay and no coinsurance. For chiropractic care, only some services are covered as routine and other chiropractic services are not covered.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers preventive services, including annual physicals, kidney disease education, and fitness benefits with no copay and no coinsurance. Additional preventive benefits are partially covered, excluding services like health education, nutritional training, and personal emergency response systems, while select screenings like EKGs and digital rectal exams require a 20% coinsurance and no copay.
Hearing services are partially covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP), featuring one routine hearing exam annually with no copay and a 20% coinsurance, plus up to two OTC hearing aids every two years with no copay or coinsurance. Prescription hearing aids are covered up to $1,500 every two years with no copay or coinsurance, though fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services are covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with no copay, no coinsurance, and no deductible, featuring a $250 annual maximum for eyewear. The plan partially covers these services, providing one routine eye exam, contact lenses, eyeglass lenses, and eyeglass frames per year, while other eye exams, combined eyeglasses (lenses and frames), and upgrades are not covered.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) offers partially covered dental services, though implant services and orthodontics are not covered. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $1,500 annual limit.
Home infusion bundled services are covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, with prior authorization required for home infusion services.
Dialysis services are covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers medical equipment, offering durable medical equipment (DME), prosthetics, and diabetic supplies with no copays. A 20% coinsurance applies to DME, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts, and prior authorization is required for these services.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization, offering diagnostic radiological services with no copay and no coinsurance. Lab services have no copay, diagnostic procedures require a copay and a minimum 20% coinsurance, and therapeutic radiology and outpatient X-rays require no copay and a minimum 20% coinsurance.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac rehabilitation services are covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with no copay, though prior authorization and referrals are required. While some services are covered, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete TX-Q3 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization and referrals are required. This benefit is partially covered, allowing for admission with less than a three-day prior hospital stay but excluding coverage for additional days beyond the standard Medicare-covered limit.
UHC Dual Complete TX-Q3 (HMO-POS D-SNP) provides partial coverage for other services, featuring over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered. Covered OTC benefits include nicotine replacement therapy and naloxone with no maximum plan coverage limit.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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* 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.
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