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UHC Dual Complete WA-S3 (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-S3 (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-S3 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WA-S3 (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-S3 (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-S3 (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-S3 (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-S3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $10.50. 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 $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 WA-S3 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members benefit from no copay for a 1-month or 3-month supply at standard pharmacies, as well as no copay for a 3-month standard mail order supply. For Tier 2 generic drugs and Tier 3 preferred brand drugs, you will pay a 25% coinsurance for 1-month and 3-month supplies at standard pharmacies and through standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty tier drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order.
Additional Benefits
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan offers robust healthcare coverage with no copay for primary care, specialist visits, and preventative services, though some outpatient care may require up to 20% coinsurance. Inpatient hospital stays require a $1,995 copay per stay, while emergency room visits carry a $115 copay that is waived upon admission. Additionally, skilled nursing facility stays and home health services are fully covered with no copay and no coinsurance. This plan also features valuable extra benefits, including routine dental care up to a $2,500 annual limit and routine vision care with no copay. Members can access covered hearing aids, home health care, and up to 24 one-way transportation trips per year with no copay. Essential medical resources like durable medical equipment and dialysis require no copay but do carry a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services under UHC Dual Complete WA-S3 (HMO-POS D-SNP) are partially covered, featuring a $1,995 copayment per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. While unlimited additional acute care days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete WA-S3 (HMO-POS D-SNP) covers outpatient services with no copays, though coinsurance ranging from 0% to 20% and prior authorization are required for most care. Covered services include outpatient hospital and observation services, ambulatory surgical center visits, outpatient substance abuse treatment, and blood services.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP), with ground and air ambulance services requiring prior authorization and a 20% coinsurance with no copay. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete WA-S3 (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 have a copay ranging from $0 to $40 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-S3 (HMO-POS D-SNP) covers primary care, specialist, and mental health services with no copay and coinsurance ranging from no coinsurance to 20%. Therapy services require no copay and 20% coinsurance, and chiropractic care is partially covered, offering up to 12 routine visits annually with no copay and 20% coinsurance while other chiropractic services are not covered.
Preventive Services See details
Preventive Services under the UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan are partially covered, offering an annual physical exam, fitness benefits, and diabetes training with no copay and no coinsurance. While digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance and no copay, several other services—including health education, in-home safety assessments, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP), which includes one routine hearing exam annually with a 20% coinsurance and no copay, while hearing aid fittings and evaluations are not covered. Prescription hearing aids (excluding inner, outer, and over-the-ear types) and OTC hearing aids are covered with no copay and no coinsurance for up to two hearing aids every two years, with a $2,200 maximum benefit limit for prescription devices.
Vision Services See details
Vision services are partially covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with no copay, no coinsurance, and no deductible, offering one routine eye exam and a $200 annual limit for contacts, eyeglass lenses, and frames. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP), offering Medicare-covered dental services with no copay and 20% coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $2,500 annual maximum. Implant services and orthodontics are not covered under this plan, and prior authorization is required for some services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay, while chemotherapy and other Part B drugs have no copay, with all of these drugs carrying a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Dual Complete WA-S3 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment and prosthetics, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete WA-S3 (HMO-POS D-SNP) covers diagnostic and radiological services, requiring prior authorization for all services. Diagnostic procedures and tests require both a copay and 20% coinsurance, while lab services have no copay. Diagnostic radiological services feature no copay and no coinsurance, but therapeutic radiological and outpatient X-ray services require 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with no copay and prior authorization required, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Dual Complete WA-S3 (HMO-POS D-SNP) with no copayment and no coinsurance, though prior authorization is required. While the plan does not require a three-day prior hospital stay for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete WA-S3 (HMO-POS D-SNP) partially covers Other Services with no copay and no coinsurance, which includes up to 12 acupuncture treatments per year, over-the-counter items, and prior-authorized meal benefits for chronic illnesses. Highly integrated services for dual eligible SNPs are not covered under this benefit.
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