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UHC Dual Complete WA-V001 (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-V001 (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-V001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete WA-V001 (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-V001 (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-V001 (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-V001 (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-V001 (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 $6700.00 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-V001 (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. This plan's premium may be reduced if you qualify for the low-income subsidy, and if you do, you will pay $26.20 for Part D. Once your total drug costs reach $2000, you enter the Catastrophic Coverage Phase, where you will pay nothing for your Part D covered drugs. Please note that the specific costs for each drug tier are not available in this summary.
Additional Benefits
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan offers comprehensive coverage with varying cost-sharing. Inpatient hospital stays have a copay, with no copay for days 6-90. Outpatient, primary care, preventive, and many other services have no copay, while others have copays ranging from $15 to $450. This plan provides coverage for hearing, vision, and dental services. Hearing services include routine exams and hearing aids with copays, vision services cover eye exams and eyewear with no copay, and dental services include a $1500 annual maximum.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care. For days 1-5, there is a $450 copay, and for days 6-90, there is no copay; additional days for acute care have no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, outpatient substance abuse services, outpatient blood services, and ambulatory surgical center services. Outpatient hospital services have a copay between $0 and $450, observation services have a $450 copay, ambulatory surgical center services have no copay, and outpatient blood services have no copay. Individual sessions for outpatient substance abuse have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, but prior authorization is required. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $290 copay, and transportation services to plan-approved health-related locations with no copay for up to 24 one-way trips per year via taxi or medical transport. 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. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $45, while Worldwide Emergency Services have no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan covers primary care physician services, chiropractic services with no copay, occupational therapy services with a copay between $0 and $25, and physician specialist services with a copay between $0 and $35. This plan also covers mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services with a copay between $0 and $25, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine chiropractic care is limited to 12 visits per year.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, and additional preventive services. Annual physical exams have no copay, while some additional preventive services, such as fitness benefits, have no copay.
Hearing Services See details
Hearing Services include routine hearing exams with no copay, and prescription hearing aids with a copay between $199 and $1249 for all types, and OTC hearing aids with a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include coverage for eye exams and eyewear. Eye exams have no copay, and eyewear has a combined maximum benefit of $400 every two years, with no copay for Contact Lenses and Eyeglass frames, and a copay of $0 - $153 for Eyeglass lenses. Eyeglasses (lenses and frames) and Upgrades are not covered.
Dental Services See details
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan covers Medicare dental services with 20% coinsurance, and other dental services with a $1500 annual maximum. Oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services have no copay, while restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, prosthodontics (removable and fixed), and oral and maxillofacial surgery also have no copay. The plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance. Prosthetics/Medical Supplies and Diabetic Equipment are also covered, with specific services having a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include Diagnostic Procedures/Tests with a $30 copay, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $250, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with a $25 copay. All radiological services require prior authorization.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $180 copay for days 21-100.
Other Services See details
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan covers acupuncture with no copay, and up to 12 treatments per year. Over-the-counter items are covered with no copay, including nicotine replacement therapy and naloxone, but not all drugs on the CMS OTC list. This plan also offers a meal benefit for a chronic illness with no copay. Other services such as Early and Periodic Screening, Diagnostic, and Treatment services, private duty nursing services, and more are not covered.
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