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UHC Complete Care TX-18 (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-18 (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-18 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care TX-18 (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 Select Counties in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC Complete Care TX-18 (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-18 (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-18 (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-18 (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 $355.00 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 $3700.00 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-18 (HMO-POS C-SNP) Medicare plan features an annual prescription drug deductible of $355. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for a 1-month or 3-month supply at a standard pharmacy, as well as no copay for a 3-month supply through standard mail order. This ensures that many common, everyday maintenance medications are available at no cost to the policyholder. For brand-name and specialty medications, costs are determined by coinsurance percentages during the initial coverage phase. Tier 3 preferred brand drugs have a 24% coinsurance for standard pharmacy and mail order services. Tier 4 non-preferred drugs require a 45% coinsurance, while Tier 5 specialty drugs have a 29% coinsurance for a 1-month supply.
Additional Benefits
The UHC Complete Care TX-18 (HMO-POS C-SNP) offers robust medical coverage with no copay and no coinsurance for primary care visits, telehealth, and preventive services, while specialist visits require a copay of up to $15. For hospital stays, members pay a $150 daily copay for the first six days of inpatient care and no copay for days 7 through 90. Emergency room visits carry a $150 copay, which is waived if admitted, while urgent care ranges from no copay to a $65 copay. This plan also features valuable everyday benefits, including routine dental, vision, and hearing exams with no copay, alongside a $150 eyewear allowance and up to 36 free one-way transportation trips per year. While durable medical equipment and dialysis services require a 20% coinsurance with no copay, members enjoy no copay for home health services, laboratory tests, and over-the-counter items.
Inpatient Hospital See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $150 daily copay for days 1 through 6 and no copay for days 7 through 90. While unlimited additional acute stay days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $150 copay for outpatient hospital services and a $150 daily copay for observation services. Ambulatory surgical center and outpatient blood services have no copay, while outpatient substance abuse sessions range from no copay to a $25 copay, with prior authorization and referrals required for most services.
Partial Hospitalization See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers partial hospitalization benefits with no copay and no coinsurance. Both prior authorization and a referral are required to access these covered services.
Ambulance and Transportation Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from $0 to $65 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care TX-18 (HMO-POS C-SNP) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits and therapy services require a copay of up to $15 with no coinsurance. Individual mental health and psychiatric sessions range from no copay to a $25 copay with no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Complete Care TX-18 (HMO-POS C-SNP) with no copay and no coinsurance for covered options like annual physical exams, kidney disease education, and fitness benefits. Several sub-services are not covered under this plan, including health education, personal emergency response systems, medical nutrition therapy, in-home support, and weight management programs.
Hearing Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) offers partially covered hearing services, featuring one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription hearing aids with a copay of $199.00 to $1,249.00 and two OTC hearing aids with a copay of $199.00 to $829.00 are covered annually with no coinsurance, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) provides partially covered vision services with no deductible and no coinsurance, including one routine eye exam per year with no copay. Eyewear is covered up to $150 every two years with no copay for contact lenses or frames and a $0 to $153 copay for lenses, though other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Complete Care TX-18 (HMO-POS C-SNP), with implant services and orthodontics excluded from coverage. Preventive and diagnostic care are offered with no copay and no coinsurance up to a $1,500 annual limit, whereas Medicare-covered services carry no copay and a 20% coinsurance, and other covered comprehensive services have no copay and a 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care TX-18 (HMO-POS C-SNP) with no copay, subject to prior authorization. Associated Medicare Part B chemotherapy and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin drugs require a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
UHC Complete Care TX-18 (HMO-POS C-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 Complete Care TX-18 (HMO-POS C-SNP) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment and supplies, including therapeutic shoes or inserts, are also covered with no copay and no coinsurance, though prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) covers diagnostic and radiological services, with prior authorization and referrals required. Lab services and diagnostic radiological services have no copay and no coinsurance, while diagnostic tests require a $50 copay, outpatient X-rays require a $25 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Complete Care TX-18 (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive this benefit.
Cardiac Rehabilitation Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) does not cover Cardiac Rehabilitation Services. Consequently, there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) services under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Complete Care TX-18 (HMO-POS C-SNP) with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization and referrals are required, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
UHC Complete Care TX-18 (HMO-POS C-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered, and prior authorization is required for the meal benefit.
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