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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 2025, 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 out of 5 stars in 2025.
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 $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 $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 WA-S3 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your 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 (LIS), you will pay $26.20 for Part D. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $2000 copay, while outpatient services and primary care often have coinsurance between 0% and 20%. Emergency services have a $110 copay, and other services like vision exams, home health, and many preventive services have no copay. This plan includes dental, hearing, and vision coverage, with specific benefits and cost-sharing arrangements. It also offers coverage for ambulance, home infusion, and medical equipment, each with its own cost structure. Additionally, the plan covers acupuncture, over-the-counter items, and a meal benefit with no copay, providing a comprehensive set of healthcare services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric is not covered. For Inpatient Hospital-Acute, the copay is $2000 per stay, and for Additional Days from days 91-999, there is no copay.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services are covered. Outpatient Hospital Services have a coinsurance between 0% and 20%, Observation Services have a 20% coinsurance, Individual Sessions for Outpatient Substance Abuse have a coinsurance between 0% and 20%, Group Sessions for Outpatient Substance Abuse have a 20% coinsurance, and Outpatient Blood Services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location has no copay. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered. Emergency services have a $110 copay, while urgently needed services have a copay between $0 and $45, and worldwide emergency services have no copay.
Primary Care See details
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician and physician specialist services have a coinsurance of 0% - 20%, while chiropractic services have a 20% coinsurance and routine care has no copay. Occupational therapy services, mental health specialty services, other health care professional services, psychiatric services, and physical therapy and speech-language pathology services have a coinsurance of 0% - 20%. Additional telehealth benefits and opioid treatment program services have no copay. Podiatry services have a 20% coinsurance, and routine foot care has a $0 copay.
Preventive Services See details
Preventive Services, including Medicare-covered services, are covered by the UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan. Annual physical exams have no copay. Other preventive services, such as Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, and Barium Enemas, have no copay. Digital Rectal Exams and EKG following Welcome Visit have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered, with a maximum benefit of $2200 per year, and OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams have no copay, and routine eye exams are covered once per year. Eyewear has no copay, and the plan covers contact lenses, eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 per year. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis, fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, maxillofacial prosthetics, prosthodontics, fixed, and oral and maxillofacial surgery are covered with no copay.
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 20% coinsurance. Prior authorization is required.
Medical Equipment See details
Medical Equipment is covered by the UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan, with a 20% coinsurance for Durable Medical Equipment, Medicare-covered Prosthetic Devices, and Medicare-covered Medical Supplies. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete WA-S3 (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-S3 (HMO-POS D-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. Prior authorization is required, and the plan charges the Medicare-defined cost share for tier 1, with more copay information available.
Other Services See details
The UHC Dual Complete WA-S3 (HMO-POS D-SNP) plan covers acupuncture with no copay, and also covers over-the-counter items with no copay, including nicotine replacement therapy and Naloxone. The plan also offers a meal benefit with no copay. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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