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UHC Complete Care TX-17 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care TX-17 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care TX-17 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care TX-17 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in El Paso County. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that UHC Complete Care TX-17 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care TX-17 (HMO-POS C-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 Complete Care TX-17 (HMO-POS C-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 Complete Care TX-17 (HMO-POS C-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 $340.00 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 $3900.00 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 Complete Care TX-17 (HMO-POS C-SNP) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, for a standard pharmacy, preferred generic drugs have no copay, standard generic drugs have a $47 copay, and preferred brand drugs have a $100 copay. Non-preferred drugs have 29% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The UHC Complete Care TX-17 (HMO-POS C-SNP) plan offers a range of benefits with varying costs. For inpatient hospital stays, you'll pay a $175 copay for the first five days, and no copay for the rest. Outpatient services have copays between $0 and $175, while emergency services have a $140 copay. This plan includes no copay for primary care, hearing exams, vision exams, eyewear, and many dental services. Ambulance services and some specialist services have copays, and additional services like home health, home infusion, and skilled nursing facilities are covered with copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both of which require prior authorization and a doctor referral. For Inpatient Hospital-Acute, you pay a $175 copay for days 1-5, and no copay for days 6-90, while Inpatient Hospital Psychiatric has a $175 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a copay between $0 and $175, observation services with a $175 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered, and requires prior authorization and a doctor referral. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, each with a $275 copay. Transportation Services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year via taxi or medical transport. 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 by the UHC Complete Care TX-17 (HMO-POS C-SNP) plan. Emergency Services has a $140 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The UHC Complete Care TX-17 (HMO-POS C-SNP) plan covers Primary Care Physician services with no copay, Chiropractic Services with a $20 copay, and Occupational Therapy Services with a $0-$10 copay. The plan also covers Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional services, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, each with varying copays. However, Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar preventive services, annual physical exams with no copay, and additional preventive services. Additional preventive services are covered, but with a copay for fitness benefits, and home and bathroom safety devices and modifications. Other services like health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one visit every year. Prescription hearing aids (all types) are covered with a copay between $199 and $1249 for two visits every year, and OTC hearing aids are covered with a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Eye exams and eyewear have no copay, while contact lenses, eyeglass lenses, and eyeglass frames have a copay of $0. 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, and a $2,000 maximum benefit per year for other dental services. Oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, and other preventive dental services have no copay, though the number of visits and periodicity vary by service. Restorative Services, and Oral and Maxillofacial Surgery have no copay. Prosthodontics, fixed, and Prosthodontics, removable have 0-50% coinsurance. Implant Services and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable medical equipment has a 20% coinsurance with prior authorization required, while durable medical equipment for use outside the home is not covered. Medical supplies and prosthetic devices have a 20% coinsurance, and diabetic supplies and diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay, lab services with no copay, and radiological services. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have at least 20% coinsurance, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by UHC Complete Care TX-17 (HMO-POS C-SNP) 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 specific services like Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation 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 with prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $203. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Complete Care TX-17 (HMO-POS C-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. OTC items have no copay, and meal benefits also have no copay, but require prior authorization. Other services like Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many additional services are not covered.
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