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UHC Complete Care ID-13 (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-13 (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-13 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care ID-13 (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-13 (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-13 (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-13 (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-13 (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 $6300.00 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-13 (HMO-POS C-SNP) plan has an enhanced alternative drug benefit. The plan has a deductible of $340.00. In the initial coverage phase, you will pay a copay for your drugs. For standard generic drugs, you will pay a $10.00 copay, while preferred brand drugs have a $100.00 copay. Non-preferred drugs have a 29% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, and you will pay nothing for your Part D covered drugs.
Additional Benefits
The UHC Complete Care ID-13 (HMO-POS C-SNP) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a $450 copay for the first 5 days, with no copay for most of the stay, while outpatient services and doctor visits often have copays between $0 and $450. The plan also covers preventive services with no copay, along with hearing, vision, and dental services, and covers prescription hearing aids. Additionally, the plan covers services like ambulance, emergency care, home health, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered under the UHC Complete Care ID-13 (HMO-POS C-SNP) plan. For days 1-5, there is a $450 copay, and for days 6-90, there is no copay; additional days for acute inpatient hospital care have no copay, and 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 $450, Observation Services with a $450 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. Outpatient Blood Services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care ID-13 (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 by the UHC Complete Care ID-13 (HMO-POS C-SNP) plan. Ground and Air Ambulance Services have a copay of $290, with no coinsurance. 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-13 (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, Urgently Needed Services have a copay between $0 and $55, and Worldwide Emergency Services has a copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services are covered with no copay, and Chiropractic Services are covered with a $20 copay and require prior authorization. Occupational Therapy Services are covered with a copay between $0 and $35, and Physician Specialist Services are covered with a copay between $0 and $40. Individual and Group Sessions for Mental Health Specialty Services are covered with copays ranging from $0 to $25 and $15, respectively. Podiatry Services are covered with a $40 copay. Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services are covered with copays between $0 and $40. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $35, and Additional Telehealth Benefits are covered with no copay.
Preventive Services See details
The UHC Complete Care ID-13 (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, 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 are not covered. The plan also covers Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one exam per year. Prescription and OTC hearing aids are also covered, with copays between $99 and $1249 depending on the type of hearing aid. Fitting/evaluation for hearing aids, and prescription hearing aids for inner, outer, or over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, contact lenses, and eyeglass lenses. Eye exams and eyewear have no copay, while eyeglass lenses have a copay of $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Complete Care ID-13 (HMO-POS C-SNP) plan covers Medicare Dental Services with 20% coinsurance, and other dental services including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. However, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the UHC Complete Care ID-13 (HMO-POS C-SNP) plan and require prior authorization. For Medicare Part B insulin drugs, there is a $35 copay, with coinsurance between 0% and 20%. Other Medicare Part B drugs, as well as Medicare Part B Chemotherapy/Radiation Drugs, have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Complete Care ID-13 (HMO-POS C-SNP) plan. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment with 20% coinsurance, Prosthetic Devices with 20% coinsurance, Medical Supplies with 20% coinsurance, and Diabetic Equipment, with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a $50 copay for diagnostic procedures and tests, 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%, and outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care ID-13 (HMO-POS C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the UHC Complete Care ID-13 (HMO-POS C-SNP) plan, but the plan does not cover any of the sub-services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Complete Care ID-13 (HMO-POS C-SNP) with a $0 copay for days 1-20 and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The UHC Complete Care ID-13 (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. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and Case Management are not covered.
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