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UHC Complete Care TX-19 (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-19 (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-19 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care TX-19 (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-19 (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-19 (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-19 (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-19 (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 $3600.00 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 Complete Care TX-19 (HMO-POS C-SNP)
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Drug Coverage
The UHC Complete Care TX-19 (HMO-POS C-SNP) prescription drug plan features an annual drug deductible of $355. Beneficiaries will enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This ensures that essential, everyday generic medications remain highly accessible and affordable. For higher-tier medications, cost-sharing is structured as coinsurance. You will pay a 24% coinsurance for Tier 3 preferred brand drugs, a 43% coinsurance for Tier 4 non-preferred drugs, and a 29% coinsurance for Tier 5 specialty tier drugs. These coinsurance rates apply to standard pharmacy and standard mail-order services.
Additional Benefits
The UHC Complete Care TX-19 (HMO-POS C-SNP) plan offers comprehensive coverage with predictable, low out-of-pocket costs for essential medical services. Beneficiaries enjoy no copay and no coinsurance for primary care visits, home health services, and routine preventive care, while specialist visits require a low copay of up to $15. Inpatient hospital stays require a $250 daily copay for the first five days followed by no copay for additional days, while emergency room visits carry a $150 copay that is waived if you are admitted. This plan also includes valuable dental, vision, and hearing benefits to support your everyday health. Routine eye exams, annual hearing tests, and preventive dental care up to a $1,500 annual limit are all available with no copay and no coinsurance. Additionally, diabetic supplies are fully covered with no copay, while durable medical equipment and dialysis services carry a standard 20% coinsurance.
Inpatient Hospital See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a $250 copay for days 1 through 5 and no copay for days 6 through 90 for both acute and psychiatric stays. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered under UHC Complete Care TX-19 (HMO-POS C-SNP) with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $250, observation services carry a $250 daily copay, and outpatient substance abuse services range from a $0 to $25 copay, all with no coinsurance.
Partial Hospitalization See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers partial hospitalization services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance, while rides to any health-related location are not covered.
Emergency Services See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are 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-19 (HMO-POS C-SNP) offers primary care and telehealth services with no copay and no coinsurance, while specialist visits range from a $0 to $15 copay with no coinsurance. Therapy and podiatry services require a $15 copay, mental health services range from a $0 to $25 copay, and there is no coinsurance for these benefits. Some chiropractic services are covered, but routine and other chiropractic care are not covered.
Preventive Services See details
Preventive services are partially covered under UHC Complete Care TX-19 (HMO-POS C-SNP) with no copay and no coinsurance for covered options like annual exams, fitness benefits, and kidney education. Uncovered sub-services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, caregiver support, in-home support, smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care TX-19 (HMO-POS C-SNP), offering one annual routine hearing exam with no copay, no coinsurance, and no deductible, though fitting and evaluation exams are not covered. Additionally, up to two prescription hearing aids (copay of $199 to $1,249) and two OTC hearing aids (copay of $199 to $829) are covered per year with no coinsurance, while inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Complete Care TX-19 (HMO-POS C-SNP) with no coinsurance, offering no copay for annual routine eye exams, contact lenses, and eyeglass frames, and a $0 to $153 copay for lenses up to a $300 limit every two years. Other eye exam services, upgrades, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Complete Care TX-19 (HMO-POS C-SNP), featuring preventive care with no copay and no coinsurance up to a $1,500 annual maximum. Medicare-covered dental services have no copay and a 20% coinsurance, while covered comprehensive services have no copay and a 50% coinsurance; however, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs are covered with coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Complete Care TX-19 (HMO-POS C-SNP) 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-19 (HMO-POS C-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the UHC Complete Care TX-19 (HMO-POS C-SNP) plan, with referrals and prior authorizations required. Diagnostic tests have a $50 copay with no coinsurance, lab and diagnostic radiological services feature no copay, and outpatient X-rays require a $25 copay plus coinsurance, while therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Complete Care TX-19 (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
UHC Complete Care TX-19 (HMO-POS C-SNP) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization and a referral are required. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Complete Care TX-19 (HMO-POS C-SNP) with no coinsurance, requiring both prior authorization and a referral. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Complete Care TX-19 (HMO-POS C-SNP), offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and Dual Eligible SNP services are not covered under this plan, and the meal benefit requires prior authorization.
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