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UHC Dual Complete WA-S6 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WA-S6 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Dual Complete WA-S6 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WA-S6 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Washington. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete WA-S6 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Dual Complete WA-S6 (HMO-POS D-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 Dual Complete WA-S6 (HMO-POS D-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 Dual Complete WA-S6 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $10.50. 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 $615.00 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 $9250.00 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 Dual Complete WA-S6 (HMO-POS D-SNP)
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Drug Coverage
The UHC Dual Complete WA-S6 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members enjoy no copay for one-month and three-month supplies filled at standard pharmacies or through standard mail order. This ensures affordable access to essential everyday medications. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan charges a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy and standard mail order fills for one-month or three-month supplies depending on the tier. These clear cost-sharing structures help you accurately estimate your out-of-pocket prescription costs under this plan.
Additional Benefits
The UHC Dual Complete WA-S6 (HMO-POS D-SNP) offers robust coverage for essential medical services, with many key benefits requiring no copay. Primary care visits, home health services, skilled nursing facility care, and outpatient services feature no copay, though some outpatient services may require a coinsurance of up to 20%. For more intensive care, inpatient hospital stays require a copay of $2,150 per acute stay or $2,080 per psychiatric stay, while emergency room visits carry a $115 copay that is waived if you are admitted. This plan also includes strong coverage for routine wellness care, featuring no copay or coinsurance for annual physicals, fitness benefits, and routine vision exams with a $200 annual eyewear allowance. Dental care is covered with no copay or coinsurance for most preventive and comprehensive services up to a $2,500 annual limit, and routine hearing exams are available with no copay and a 20% coinsurance. Additionally, members benefit from no copay on routine acupuncture, select over-the-counter items, and up to 24 one-way transportation trips per year to plan-approved locations.
Inpatient Hospital See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers inpatient hospital services with no coinsurance, requiring prior authorization and a copay of $2,150 per acute stay or $2,080 per psychiatric stay. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute days are covered with no copay.
Outpatient Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers outpatient services with no copay, though you may be responsible for a coinsurance of 0% to 20% depending on the service. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse therapy, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to 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, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with a $115 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no coinsurance and a copay ranging from no copay to $40, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under UHC Dual Complete WA-S6 (HMO-POS D-SNP) are covered with no copay and coinsurance ranging from no coinsurance to 20%, though prior authorizations and referrals are required for many services. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP), with annual physicals, kidney education, and fitness benefits requiring no copay and no coinsurance, while digital rectal exams and post-Welcome Visit EKGs require a 20% coinsurance and no copay. Sub-services that are not covered include health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services under UHC Dual Complete WA-S6 (HMO-POS D-SNP) are partially covered, offering annual routine hearing exams with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance, though a $2,200 limit applies to prescription aids every two years, and inner ear, outer ear, and over-the-ear types are not covered.
Vision Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) offers partially covered vision services with no copay and no coinsurance, including one routine eye exam per year and eyewear up to a $200 annual limit. Covered eyewear options include contact lenses, eyeglass lenses, and frames, while other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) offers partially covered dental services, featuring no copay and no coinsurance for most preventive and comprehensive services up to a $2,500 annual limit, while Medicare-covered dental services require a 20% coinsurance and no copay. Implant services and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, insulin, and other drugs, have a coinsurance ranging from no coinsurance up to 20%, with insulin requiring a $35 copay.
Dialysis Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with no copay and 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies feature no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with prior authorization required. Diagnostic procedures require a copay and a minimum 20% coinsurance, while lab services have no copay but require coinsurance. Diagnostic radiological services carry no copay and no coinsurance, while therapeutic radiology and outpatient X-rays require no copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete WA-S6 (HMO-POS D-SNP) covers some Cardiac Rehabilitation Services with no copay and prior authorization, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required and a prior three-day inpatient hospital stay is not necessary. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Dual Complete WA-S6 (HMO-POS D-SNP), providing acupuncture limited to 12 treatments per year, over-the-counter items, and chronic illness meal benefits with prior authorization for no copay and no coinsurance. Highly integrated services for dual-eligible SNPs and other miscellaneous services are not covered.
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