A non-government entity
UHC Dual Complete TX-D003 (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-D003 (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-D003 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete TX-D003 (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 Cameron, Hidalgo, and Willacy Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete TX-D003 (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-D003 (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-D003 (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-D003 (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 $122.00 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:
Sign up for UHC Dual Complete TX-D003 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete TX-D003 (HMO-POS D-SNP) Medicare plan features an annual drug deductible of $122. For generic medications, this plan offers excellent savings with no copay for Tier 1 preferred generics and Tier 2 generics filled at standard pharmacies or through standard mail order. This ensures that essential everyday prescription drugs remain highly affordable for members. For brand-name and specialty medications, members will pay a 25% coinsurance. This 25% coinsurance applies to Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs when filled at standard pharmacies or through standard mail order. This straightforward cost-sharing structure helps you easily project your out-of-pocket prescription expenses.
Additional Benefits
The UHC Dual Complete TX-D003 (HMO-POS D-SNP) plan offers comprehensive medical coverage with no copays for primary care, specialist visits, and outpatient services, though coinsurance up to 20% may apply. Inpatient hospital stays require a flat copay of $2,230 for acute stays and $2,080 for psychiatric stays, both with no coinsurance for covered days. Emergency room visits carry a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For routine care, this plan features dental benefits with no copay or coinsurance up to a $1,500 annual limit, as well as vision and hearing aid coverage with no copay, coinsurance, or deductible. Additionally, members can access home health care and skilled nursing services with no copay or coinsurance, plus up to 24 free one-way transportation trips per year to plan-approved locations.
Inpatient Hospital See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) provides partially covered inpatient hospital services with no coinsurance, though prior authorization and referrals are required. Medicare-covered acute stays require a $2230 copay per stay with unlimited additional days at no copay, and psychiatric stays require a $2080 copay per stay, but non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copays, although coinsurance may apply depending on the service. Ambulatory surgical, outpatient hospital, and substance abuse services feature no copay and range from no coinsurance to 20% coinsurance, while outpatient blood and observation services require no copay and 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. This benefit requires both a referral and prior authorization.
Ambulance and Transportation Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations via taxi or medical transport with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no coinsurance and a copay ranging from no copay up to $40, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and specialist services under the UHC Dual Complete TX-D003 (HMO-POS D-SNP) plan are covered with no copay and 0% to 20% coinsurance, while telehealth and opioid treatment have no copay and no coinsurance. Physical, occupational, and speech therapy services are covered with no copay and 20% coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers most preventive services, including annual physical exams and fitness benefits, with no copay and no coinsurance. However, the benefit is only partially covered, as digital rectal exams and post-welcome visit EKGs require a 20% coinsurance with no copay, and services like health education, personal emergency response systems (PERS), and nutritional benefits are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP), which offers one routine hearing exam annually with a 20% coinsurance and no copay, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay, no coinsurance, and no deductible, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copay, no coinsurance, and no deductible for covered services, including one routine eye exam and up to $200 annually for contact lenses, eyeglass lenses, and frames. Other eye exam services, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance up to a $1,500 annual limit. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copay, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these covered services.
Medical Equipment See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers durable medical equipment (DME), prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts have a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete TX-D003 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization and referral requirements. Diagnostic tests require a copay and a minimum 20% coinsurance, lab services require coinsurance with no copay, and radiological services have no copay, featuring no coinsurance for diagnostic radiology and a minimum 20% coinsurance for therapeutic and X-ray services.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copay, but some services are not covered, including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation. These excluded services require a 20% coinsurance, and prior authorization and referrals are required for covered benefits.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP) with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization and referrals are required for this benefit, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete TX-D003 (HMO-POS D-SNP), as acupuncture, meal benefits, and highly integrated dual-eligible services are not covered. Select over-the-counter items, including nicotine replacement therapy and naloxone, are covered with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved