A non-government entity
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 2026, 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 3.5 out of 5 stars in 2026.
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 $10.00. 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 $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 $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:
Sign up for UHC Dual Complete WA-V001 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) Medicare plan has an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for 1-month and 3-month supplies at standard pharmacies or through standard mail order. This plan provides a clear and predictable cost structure for your everyday generic medications. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members pay a 25% coinsurance. This 25% coinsurance rate applies to 1-month and 3-month supplies at standard pharmacies and standard mail order, though Tier 4 and Tier 5 coverage is limited to 1-month supplies. Knowing these cost-sharing details helps you estimate your out-of-pocket expenses for brand-name and specialty prescriptions.
Additional Benefits
The UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan offers comprehensive medical coverage with many essential services available at low or no cost to members. You will pay no copay and no coinsurance for primary care visits, telehealth services, and routine preventive care. For hospital care, inpatient stays require a $470 daily copay for the first few days with no coinsurance, while outpatient hospital services feature copays ranging from no copay up to $470. This plan also includes valuable supplemental benefits, such as routine dental, vision, and hearing exams with no copay, though coinsurance or copays apply to comprehensive dental care, eyewear, and hearing aids. Members can also take advantage of routine acupuncture, over-the-counter items, and up to 24 one-way transportation trips per year with no copay. Most durable medical equipment, dialysis, and Medicare-covered dental services require a 20% coinsurance with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no coinsurance, requiring a $470 daily copay for days 1-5 of acute stays (no copay for days 6 and beyond) and a $470 daily copay for days 1-4 of psychiatric stays (no copay for days 5-90). Prior authorization is required, and certain services such as non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) covers outpatient services with no coinsurance, though prior authorization is required. You will pay no copay for ambulatory surgical center and blood services, a copay of $0.00 to $470.00 for outpatient hospital and observation services, and a copay of $0.00 to $25.00 for outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) covers ground and air ambulance services with a $290 copay, no coinsurance, and prior authorization required. Transportation services are partially covered with no copay and no coinsurance, offering up to 24 one-way trips per year to plan-approved health-related locations, while transport to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay ranging from $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits and therapy services have copays ranging from $0 to $50 and no coinsurance. Chiropractic care is partially covered, offering up to 12 routine visits per year with no copay and no coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, caregiver support, and kidney disease education. However, several supplemental options are not covered, including health education, personal emergency response systems (PERS), nutritional/dietary benefits, alternative therapies, therapeutic massage, and in-home safety assessments.
Hearing Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) partially covers hearing services, offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. Up to two prescription or OTC hearing aids are covered per year with no coinsurance, featuring copays ranging from $199.00 to $1,249.00 for prescription and $199.00 to $829.00 for OTC devices, but inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) partially covers vision services, providing routine eye exams with no copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no coinsurance and copays ranging from $0 to $153 up to a $150 combined limit every two years, though upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) provides partially covered dental services, with implant services and orthodontics not covered. Preventive services feature no copay and no coinsurance up to a $1,000 yearly limit, Medicare-covered services have no copay and a 20% coinsurance, and comprehensive services require no copay and a 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) covers medical equipment with no copay for durable medical equipment (DME), prosthetics, and diabetic supplies. A 20% coinsurance applies to DME, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with prior authorization required. Diagnostic tests carry a $40 copay and lab services have no copay, both with no coinsurance, while outpatient X-rays have a $25 copay and therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete WA-V001 (HMO-POS D-SNP) plan, as none of the sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy, are covered in practice. Because these services are not covered, there is no copay and no coinsurance associated with them.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete WA-V001 (HMO-POS D-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $180 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete WA-V001 (HMO-POS D-SNP) offers coverage for acupuncture up to 12 treatments per year, over-the-counter (OTC) items, and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and other miscellaneous services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved