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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 2025, 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 2025.
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 $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 $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) plan has a $340 deductible. Once you meet your deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. For standard generic drugs, you will pay a $47 copay at the standard pharmacy. For preferred brand drugs, you will pay a $100 copay at all pharmacies. For non-preferred drugs, you will pay 29% coinsurance. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Complete Care TX-18 (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, and emergency services have a $140 copay, while many outpatient services have no copay. Preventive, vision, and hearing services have no copays, and dental services are covered with coinsurance. The plan also includes coverage for ambulance, home health, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the UHC Complete Care TX-18 (HMO-POS C-SNP) plan. For days 1-5 of inpatient hospital-acute and psychiatric care, there is a $125 copay, and for days 6-90, there is no copay. Additional days for inpatient hospital-acute care (days 91-999) have no copay. Non-Medicare-covered stays and upgrades for inpatient hospital-acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay of $0-$125, Observation Services with a $125 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a $0-$25 copay 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 with no copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $275 copay, and transportation services to a plan-approved health-related location with no copay for up to 48 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 by the UHC Complete Care TX-18 (HMO-POS C-SNP) plan. Emergency Services have a $140 copay with no coinsurance, while Urgently Needed Services have a copay between $0 and $65 with no coinsurance; Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $10, Physician Specialist Services with a copay between $0 and $10, and Mental Health Specialty Services, Psychiatric Services, and Other Health Care Professional with varying copays depending on the service. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $10, Additional Telehealth Benefits are covered with no copay, and Opioid Treatment Program Services are covered with no copay. Podiatry Services are not covered.
Preventive Services See details
Preventive services, including an annual physical exam, are covered with no copay. Additional preventive services, including fitness benefits, are covered with no copay; however, health education, in-home safety assessments, and other services are not covered.
Hearing Services See details
Hearing services with UHC Complete Care TX-18 (HMO-POS C-SNP) include hearing exams with no copay and routine hearing exams covered annually with no copay, and prescription hearing aids covered with a copay between $199 and $1249. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered, but OTC hearing aids are covered with a copay between $99 and $829.
Vision Services See details
Vision services include eye exams, eyewear, and more. Eye exams and routine eye exams have no copay, and eyewear has a combined maximum benefit of $250 every two years, with no copay for contact lenses, eyeglass frames, and eyeglass lenses. 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 treatments, 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. You will pay a $35 copay for Medicare Part B Insulin Drugs, and the coinsurance can range from 0% to 20% for all covered services.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by UHC Complete Care TX-18 (HMO-POS C-SNP). Durable Medical Equipment has no copay and a 10% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have no copay and 10% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, lab services with no copay, and all radiological services. Diagnostic radiological services have a copay of at most $175, therapeutic radiological services have a coinsurance of at most 20%, and outpatient X-ray services have a $15 copay.
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. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization and a doctor referral. For days 1-20, there is no copay, and for days 21-100, the copay is $203.
Other Services See details
Under the "Other Services" benefit, this plan covers Over-the-Counter (OTC) items and Meal Benefits, but Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. OTC items have no copay, and Meal Benefits also have no copay, but require prior authorization.
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