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UHC Complete Care ID-12 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care ID-12 (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 ID-12 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care ID-12 (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 Idaho. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that UHC Complete Care ID-12 (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 ID-12 (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 ID-12 (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 ID-12 (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 $4800.00 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 ID-12 (HMO-POS C-SNP) plan has an enhanced alternative drug benefit. The plan has a $340 deductible. After the deductible is met, you will pay a copay or coinsurance for your prescriptions. For example, you will pay a $5 copay for a preferred generic drug at a standard pharmacy. You will pay 29% coinsurance for non-preferred drugs.
Additional Benefits
The UHC Complete Care ID-12 (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $325 copay for the first six days, then no copay. Many outpatient services, primary care visits, and preventive services are covered with no copay, while others have copays ranging from $15 to $325. The plan also includes coverage for hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249. Vision services include eye exams and eyewear with no copay, and dental services offer no copay for preventive care, but with a 20% coinsurance for other Medicare dental services. Additionally, the plan provides coverage for ambulance services, home health, and skilled nursing facilities with copays or coinsurance in some cases.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. For days 1-6, there is a $325 copay, and for days 7-90 and additional days, there is no copay. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $325, Observation Services with a $325 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with no copay, and Outpatient Blood Services with no copay. Prior authorization is required for all services.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care ID-12 (HMO-POS C-SNP) plan with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $175 copay for both ground and air ambulance services, and no copay for transportation services to a plan-approved health-related location. 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 ID-12 (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55; both have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $20, Physician Specialist Services with a copay between $0 and $25, and Mental Health Specialty Services with no copay for individual and group sessions. Podiatry Services have a $25 copay, Other Health Care Professional services have a copay between $0 and $25, Psychiatric Services have no copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $20, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services, including Medicare-covered preventive services and an annual physical exam, are covered with no copay. Additional preventive services, including fitness benefits, remote access technologies, and home and bathroom safety devices and modifications, are covered with no copay. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, and Telemonitoring Services.
Hearing Services See details
The UHC Complete Care ID-12 (HMO-POS C-SNP) plan covers hearing exams with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with a copay between $199 and $1249, and OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year with no copay. Eyewear includes contact lenses, eyeglass lenses, and eyeglass frames with no copay; however, eyeglass lenses are covered once every two years, and eyeglass frames are covered once every two years. Contact lenses are covered, and there is a combined maximum of $250.00 every two years for all eyewear. Eyeglasses and upgrades are not covered.
Dental Services See details
Dental Services are covered under the UHC Complete Care ID-12 (HMO-POS C-SNP) plan, with a 20% coinsurance for Medicare Dental Services, and no copay for Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care ID-12 (HMO-POS C-SNP) plan and require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment is covered by the UHC Complete Care ID-12 (HMO-POS C-SNP) plan, with a 20% coinsurance for Durable Medical Equipment (DME), Medicare-covered Prosthetic Devices, and Medicare-covered Medical Supplies. 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 with a copay for Medicare-covered diagnostic procedures, tests, and lab services, Diagnostic Procedures/Tests with a $20 copay, and Lab Services with no copay. Diagnostic Radiological Services have a copay of at most $225, while Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care ID-12 (HMO-POS C-SNP) plan with no copay and no coinsurance, though additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Complete Care ID-12 (HMO-POS C-SNP) plan. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Complete Care ID-12 (HMO-POS C-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The UHC Complete Care ID-12 (HMO-POS C-SNP) plan covers over-the-counter items and meal benefits with no copay, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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