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UHC Dual Complete MS-S4 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete MS-S4 (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 MS-S4 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete MS-S4 (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 Mississippi. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that UHC Dual Complete MS-S4 (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 MS-S4 (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 MS-S4 (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 MS-S4 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.10. 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 MS-S4 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you will enter the next coverage phase. If you qualify for the low-income subsidy, the plan's premium may be reduced. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing options. Inpatient hospital stays have a $1415 copay per admission, while outpatient services typically have coinsurance between 0% and 20%. Emergency services have a $110 copay, and urgent care has a copay between $0 and $45, with no copay for worldwide urgent and emergency services. This plan includes coverage for primary care, hearing, vision, and dental services, with no copays for routine hearing exams, eye exams, and most dental services. The plan also covers home health services and over-the-counter items with no copays. Transportation to plan-approved health-related locations is covered with no copay, up to 60 one-way trips per year.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a copay of $1415 per admission or stay, and additional days for Inpatient Hospital-Acute have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and for Inpatient Hospital Psychiatric, additional days and non-Medicare-covered stays are also not covered.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a 0% to 20% coinsurance, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 0% to 20% coinsurance, Individual Sessions for Outpatient Substance Abuse with a 0% to 20% coinsurance, Group Sessions for Outpatient Substance Abuse with a 20% coinsurance, and Outpatient Blood Services with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location have no copay and are limited to 60 one-way trips per year, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have no copay.
Primary Care See details
The UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan covers Primary Care Physician Services with a coinsurance of 0% - 20%, Chiropractic Services with 20% coinsurance (but not routine care), Occupational Therapy Services with a coinsurance of 0% - 20%, Physician Specialist Services with a coinsurance of 0% - 20%, and Mental Health Specialty Services with a coinsurance of 0% - 20%. The plan also covers Podiatry Services with 20% coinsurance and 4 visits per year, Other Health Care Professional services with a coinsurance of 0% - 20%, Psychiatric Services with a coinsurance of 0% - 20%, Physical Therapy and Speech-Language Pathology Services with a coinsurance of 0% - 20%, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
Preventive services include Medicare-covered services and additional preventive services, with an annual physical exam covered with no copay. Additional services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing Services includes coverage for hearing exams with a coinsurance of at most 20% and routine hearing exams with no copay, and prescription hearing aids with no copay up to $2,500 every year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and contact lenses, eyeglass lenses, and eyeglass frames are covered, with eyeglass lenses and frames covered once per year, and a combined maximum of $550 per year for all eyewear.
Dental Services See details
Dental Services are covered, with Medicare Dental Services requiring prior authorization and a 20% coinsurance. Other Dental Services have a maximum plan benefit coverage of $4,000 every year. 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 are covered with no copay. Implant services and orthodontics 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, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, with a coinsurance of 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medicare-covered Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of up to 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan with no copay and no coinsurance; however, 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 MS-S4 (HMO-POS D-SNP) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required.
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 copays apply; however, the specific copay information is not provided.
Other Services See details
Under "Other Services", the UHC Dual Complete MS-S4 (HMO-POS D-SNP) plan covers over-the-counter items and meal benefits. Over-the-counter items have no copay, while meal benefits also have no copay and require prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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