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UHC Dual Complete TX-V002 (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-V002 (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-V002 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete TX-V002 (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 4.5 out of 5 stars in 2025.
It's important to know that UHC Dual Complete TX-V002 (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-V002 (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-V002 (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-V002 (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.
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 $550.00 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 $4900.00 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-V002 (HMO-POS D-SNP) plan has a $550 deductible for prescription drugs. During the initial coverage phase, after you meet your deductible, you will pay 25% coinsurance for your prescriptions, depending on the drug tier and pharmacy. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan offers comprehensive coverage with varying costs. It includes inpatient hospital stays with a $350 copay for days 1-5, and no copay for days 6-90, along with coverage for outpatient services, emergency services, primary care, preventive services, and many other services with varying copays or coinsurance. The plan also provides coverage for hearing, vision, dental, and home health services, with specific copays and coinsurance amounts. Additionally, the plan covers ambulance services, home infusion, dialysis, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered under the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan. For days 1-5, there is a $350 copay, and for days 6-90, there is no copay. Additional days for inpatient hospital acute care are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient hospital acute are not covered. Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $350, observation services with a $350 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered, with individual sessions having a copay between $0 and $25 and group sessions having a $15 copay. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization and a doctor referral are required for coverage.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan, with no coinsurance for any services. Ground and air ambulance services have a $290 copay, and transportation services to a plan-approved health-related location have no copay for up to 24 one-way trips per year. 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. Emergency Services have a $125 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $55 and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan covers Primary Care benefits, including Primary Care Physician Services with no copay. Chiropractic Services have a $20 copay, but routine care is not covered. Occupational Therapy Services are covered with a copay between $0 and $30. Physician Specialist Services, Physical Therapy, and Speech-Language Pathology Services have a copay between $0 and $30. Mental Health and Psychiatric Services for individual sessions have a copay between $0 and $25 and group sessions have a $15 copay. The plan also covers Additional Telehealth Benefits with no copay and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and the plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services. The plan offers additional preventive services such as Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, and Other Preventive Services, with no copay for each of these services.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are covered with no copay for one exam per year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids per year, but fitting/evaluation for hearing aids, inner ear hearing aids, outer ear hearing aids, and over the ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829 for two hearing aids per year.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and contact lenses are covered, while eyeglass lenses are covered with a copay between $0 and $153.00, and eyeglass frames are covered once every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
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, maxillofacial prosthetics, and oral and maxillofacial surgery have no copay. Prosthodontics (removable and fixed) have a coinsurance between 0% and 50%. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay and 0-20% coinsurance, as well as Medicare Part B chemotherapy/radiation drugs and other Medicare Part B drugs, both with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan, but require prior authorization and a doctor's referral. There is a 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and authorization required, and Prosthetics/Medical Supplies with no copay and 20% coinsurance for Medicare-covered supplies. Diabetic Equipment includes Diabetic Supplies with no copay, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay; Diagnostic Radiological Services have a copay that is at most $250.00, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete TX-V002 (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 Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan, but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Dual Complete TX-V002 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with no copay, but acupuncture, meal benefits, dual eligible SNPs with highly integrated services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management, institution for mental disease services for individuals 65 or older, services in an intermediate care facility for individuals with intellectual disabilities, case management, tobacco cessation counseling for pregnant women, freestanding birth center services, respiratory care services, family planning services, nursing home services, home and community based services, personal care services, and self-directed personal assistance services are not covered.
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