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UHC Dual Complete WI-D003 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete WI-D003 (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 WI-D003 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete WI-D003 (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 Wisconsin. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete WI-D003 (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 WI-D003 (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 WI-D003 (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 WI-D003 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $7.50. 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 WI-D003 (HMO-POS D-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are available with no copay for 1-month and 3-month supplies at standard pharmacies, as well as 3-month supplies filled through standard mail order. This coverage helps lower your out-of-pocket costs for common, everyday generic medications. For higher-tier medications, including Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance at standard pharmacies and through standard mail order. This 25% coinsurance applies to 1-month and 3-month supplies for Tiers 2 and 3, and 1-month supplies for Tiers 4 and 5. Understanding these tier costs can help you estimate your overall monthly prescription expenses under this plan.
Additional Benefits
The UHC Dual Complete WI-D003 (HMO-POS D-SNP) plan offers robust coverage for essential medical needs, frequently featuring no copays for key services. Primary care visits, outpatient hospital care, and home health services require no copays, though some outpatient services may carry a coinsurance ranging from 0% to 20%. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care per stay, with no coinsurance. For routine and supplemental care, the plan provides no-copay dental and vision benefits, including up to a $2,000 annual limit for dental services and a $200 annual limit for eyewear. Additionally, members can access OTC hearing aids and prescription hearing aid coverage up to $2,200 every two years with no copay, alongside up to 24 free one-way transportation trips annually. Durable medical equipment, dialysis, and ambulance services are also covered with no copays and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP) with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services for UHC Dual Complete WI-D003 (HMO-POS D-SNP) are covered with no copays, with coinsurance ranging from 0% to 20% depending on the specific service. Covered benefits include outpatient hospital care, ambulatory surgical center services, substance abuse treatment, and blood services, most of which require prior authorization.
Partial Hospitalization See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP) require a 20% coinsurance and no copay for both ground and air ambulance services. Transportation benefits are partially covered with no copay and no coinsurance, offering up to 24 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $40 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays and no coinsurance.
Primary Care See details
Primary Care benefits under the UHC Dual Complete WI-D003 (HMO-POS D-SNP) plan are covered with no copays and coinsurance ranging from 0% to 20% for primary care, specialist, and mental health services. Therapy services require a 20% coinsurance, telehealth and opioid treatments have no copay and no coinsurance, and routine chiropractic care is not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP), featuring no copay and no coinsurance for annual physical exams, kidney disease education, and select benefits like fitness programs and weight management. However, digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance, and several sub-services—including health education, personal emergency response systems, and nutritional benefits—are not covered.
Hearing Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) provides partially covered hearing services, featuring one annual routine hearing exam with no copay and 20% coinsurance, and OTC hearing aids with no copay or coinsurance. Prescription hearing aids are covered up to $2,200 every two years with no copay or coinsurance, but fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription models, are not covered.
Vision Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers vision services with no copay and no coinsurance, including one routine eye exam per year and a $200 annual limit on eyewear such as contact lenses, eyeglass lenses, and frames. Some services are not covered under this plan, including other eye exams, upgrades, and combined eyeglasses (lenses and frames) packages.
Dental Services See details
Dental services are partially covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP), featuring no copay and a 20% coinsurance for Medicare-covered dental services. Other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,000 annual maximum, though implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs have a coinsurance of 0% to 20%, while Medicare Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these covered medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP), with prior authorization required. Lab services have no copay, diagnostic radiology has no copay or coinsurance, and therapeutic radiology, outpatient X-rays, and diagnostic tests carry a 20% coinsurance (with copays also applying to diagnostic tests).
Home Health Services See details
UHC Dual Complete WI-D003 (HMO-POS D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Dual Complete WI-D003 (HMO-POS D-SNP) with no copay and require prior authorization, but in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for 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 covered by UHC Dual Complete WI-D003 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit does not require a three-day prior inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services for UHC Dual Complete WI-D003 (HMO-POS D-SNP) are partially covered, providing over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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