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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 2025, 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 out of 5 stars in 2025.
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 $26.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.20. You must continue to pay paying your reduced 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 $590.00 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 $9350.00 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 Dual Complete WA-S6 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs, but the specific costs for each tier are not provided in this summary. Once your total drug costs reach $2,000, you move into the next coverage phase. If you qualify for the low-income subsidy (LIS), your monthly Part D premium will be $26.20. After your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan offers a range of benefits, including coverage for inpatient hospital stays with a $2,000 copay per admission, and outpatient services with varying coinsurance. Emergency, urgent, and worldwide emergency services have no copays, while primary care, hearing, vision, and dental services are also covered with no copays or low coinsurance. This plan provides additional coverage for ambulance and transportation services, home health services, and medical equipment with varying cost-sharing. The plan also covers some additional services like acupuncture and over-the-counter items with no copay. However, this plan does not cover cardiac rehabilitation services, and some additional services may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $2,000 per admission or stay for Medicare-covered stays. Additional Days for Inpatient Hospital-Acute has no copay for days 91-999. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a coinsurance between 0% and 20%, observation services have a 20% coinsurance, ambulatory surgical center (ASC) services have a coinsurance between 0% and 20%, individual outpatient substance abuse sessions have a coinsurance between 0% and 20%, group outpatient substance abuse sessions have a 20% coinsurance, and outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to a plan-approved health-related location are also covered with no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $45 and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan covers primary care physician services with a coinsurance of 0% to 20%. Chiropractic services are covered with a 20% coinsurance, and routine chiropractic care has no copay. Occupational therapy services are covered with a coinsurance of 0% to 20%. Physician specialist services and physical therapy have a coinsurance of 0% to 20%. Mental health specialty services and psychiatric services have a coinsurance of 0% to 20% for individual sessions and 20% for group sessions. Podiatry services are covered with a 20% coinsurance, and routine foot care has no copay. Other health care professional services have a coinsurance of 0% to 20%. Additional telehealth benefits and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services with varying copays and coinsurance. The plan does not cover health education, in-home safety assessments, personal emergency response systems, 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 benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services.
Hearing Services See details
Hearing services include routine hearing exams with no copay and at most 20% coinsurance, prescription hearing aids with no copay, and OTC hearing aids with no copay; however, fitting/evaluation for hearing aids, and prescription hearing aids for inner, outer, and over the ear are not covered. Routine hearing exams are limited to 1 per year, and prescription hearing aids are limited to a maximum of $2200 per year. OTC hearing aids are limited to 2 per year.
Vision Services See details
Vision services include eye exams with no copay, and eyewear with no copay. Eyeglass lenses and frames are covered with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance. Other dental services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, all with no copay. Orthodontic services are covered under Diagnostic and Preventive Dental. Implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, you will pay a $35 copay, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for Dialysis Services is between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance; Diabetic Equipment is also covered, with 20% coinsurance for Medicare-covered Diabetic Supplies and a copay for Diabetic Therapeutic Shoes or Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of at most 20% and Lab Services with no copay. Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are covered with a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
The UHC Dual Complete WA-S6 (HMO-POS D-SNP) plan covers acupuncture with no copay for up to 12 treatments per year, and over-the-counter items with no copay, including nicotine replacement therapy and naloxone. Meal benefits are covered with no copay, but require prior authorization. However, 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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