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UHC Dual Complete LA-S003 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete LA-S003 (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 LA-S003 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete LA-S003 (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 State of Louisiana. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete LA-S003 (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 LA-S003 (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 LA-S003 (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 LA-S003 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.70. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.40. 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 $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:
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Drug Coverage
The UHC Dual Complete LA-S003 (HMO-POS D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members benefit from no copay for both one-month and three-month supplies at standard pharmacies and standard mail order. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, the plan requires a 25% coinsurance. This 25% coinsurance applies to one-month and three-month supplies for Tiers 2 and 3, and one-month supplies for Tiers 4 and 5 through standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete LA-S003 (HMO-POS D-SNP) plan offers comprehensive medical coverage with many services requiring no copay. For primary care, specialist visits, and outpatient services, you will pay no copay, though coinsurance of up to 20% may apply. Inpatient hospital stays require a $1,560 copay per admission with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. This plan also features robust supplemental benefits, including routine dental, vision, and hearing services that feature no copays and no coinsurance, subject to specific annual limits. Additionally, members can access up to 24 free one-way transportation trips per year and receive home health and skilled nursing facility care with no copay or coinsurance. Durable medical equipment and dialysis services are also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) partially covers inpatient hospital services, requiring a $1,560 copay per admission and no coinsurance for Medicare-covered acute and psychiatric stays. While unlimited additional acute days are covered at no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers outpatient services with no copays, though coinsurance ranges from no coinsurance up to 20%. Prior authorization is required for these covered benefits, which include outpatient hospital, ambulatory surgical center, substance abuse, and blood services.
Partial Hospitalization See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance, offering up to 24 one-way trips per year to plan-approved health-related locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers primary care, specialist, psychiatric, and physical therapy services with no copay and coinsurance ranging from 0% to 20%. Telehealth and opioid treatment are available with no copay and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP); annual physicals, kidney education, and fitness benefits have no copay and no coinsurance, while EKGs and digital rectal exams require a 20% coinsurance with no copay. Several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, alternative therapies, and nutritional/dietary benefits.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP), with fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription hearing aids being excluded from coverage. Routine exams are covered once annually with a 20% coinsurance and no copay, while covered prescription and OTC hearing aids feature no copay and no coinsurance, with a $1,500 maximum benefit limit every two years for prescription aids.
Vision Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) offers partially covered vision services with no copay and no coinsurance for covered routine exams and select eyewear, up to a $200 annual maximum. Covered services include one routine eye exam, contact lenses, eyeglass lenses, and frames per year, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) partially covers dental services, excluding implant services and orthodontics, up to an annual maximum benefit of $1,500. Covered Medicare dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance.
Home Infusion bundled Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP) with no copays, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP) with prior authorization required. Diagnostic radiological services feature no copay and no coinsurance, lab services have no copay but require coinsurance, and diagnostic procedures, therapeutic radiology, and X-rays carry a minimum 20% coinsurance (with diagnostic procedures also requiring a copay).
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete LA-S003 (HMO-POS D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay, though prior authorization is required. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and are subject to a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete LA-S003 (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required. This benefit is partially covered because additional days beyond Medicare-covered limits are not covered, though the plan does allow SNF admission without a prior three-day inpatient hospital stay.
Other Services See details
UHC Dual Complete LA-S003 (HMO-POS D-SNP) covers select other services, including over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, although meals require prior authorization. Acupuncture and other miscellaneous services are not covered under this benefit.
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