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UHC Dual Complete NC-D001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NC-D001 (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 NC-D001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NC-D001 (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 North Carolina. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete NC-D001 (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 NC-D001 (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 NC-D001 (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 NC-D001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.30. 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 combined Maximum Out-Of-Pocket cost of $9250.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9250.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 NC-D001 (HMO-POS D-SNP) Medicare plan features 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, and no copay for 3-month standard mail-order fills. This plan structure ensures that essential generic medications remain highly affordable. For all other drug tiers, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to standard pharmacy fills as well as standard mail-order options where available. These clear cost-sharing tiers make it easy to estimate your potential out-of-pocket medication expenses.
Additional Benefits
The UHC Dual Complete NC-D001 (HMO-POS D-SNP) plan offers comprehensive medical coverage with many essential services featuring no copay, including primary care, home health services, and skilled nursing facility care. For hospital stays, members pay an inpatient copay of $1,885 per stay with no coinsurance, while outpatient services generally have no copay and coinsurance up to 20%. Emergency care is accessible with a $115 copay, which is waived upon admission, and urgent care copays range from $0 to $40. This plan also includes valuable supplemental benefits such as dental and vision care with no copays or coinsurance, featuring a $2,000 annual dental limit and a $300 yearly eyewear allowance. Hearing services are covered with no copays for hearing aids up to $2,200 every two years, alongside routine exams. Additionally, medical equipment, dialysis, and ambulance services require no copay and a 20% coinsurance, while select transportation services are covered with no copay for up to 24 one-way trips per year.
Inpatient Hospital See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,885 copay per stay and no coinsurance, requiring prior authorization. The benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers outpatient services with no copays, though coinsurance ranges from no coinsurance up to 20% depending on the service. Covered benefits include outpatient hospital care, ambulatory surgical center services, outpatient substance abuse treatment, and blood services, most of which require prior authorization.
Partial Hospitalization See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Transportation is partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved health-related locations, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete NC-D001 (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 and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the UHC Dual Complete NC-D001 (HMO-POS D-SNP) plan are covered with no copays and coinsurance ranging from 0% to 20% for physician, specialist, therapy, and mental health services. Telehealth and opioid treatment programs are also covered with no copay and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, and diabetes training, while digital rectal exams and post-welcome visit EKGs require a 20% coinsurance. Additional supplemental benefits are partially covered, offering fitness, home safety, weight management, in-home support, and caregiver support with no copay. Non-covered services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP), featuring one routine annual exam with no copay and 20% coinsurance, plus OTC and prescription hearing aids with no copays or coinsurance. While prescription aids are covered up to $2,200 every two years, hearing aid fitting and evaluation exams, as well as inner ear, outer ear, and over-the-ear prescription aid types, are not covered.
Vision Services See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible, including one routine eye exam annually and a $300 yearly allowance for eyewear. While contact lenses, eyeglass lenses, and frames are covered, other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP), offering preventive and comprehensive care with no copay and no coinsurance up to a $2,000 annual limit, though implant services and orthodontics are not covered. Medicare-covered dental services are also provided with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay under specified manufacturers, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic radiological services feature no copay and no coinsurance, lab services have no copay but require coinsurance, diagnostic tests require both a copay and 20% coinsurance, and therapeutic radiology and outpatient X-rays have no copay and a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete NC-D001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Under the UHC Dual Complete NC-D001 (HMO-POS D-SNP) plan, some cardiac rehabilitation services are covered with no copay. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though additional days beyond the Medicare-covered limit are not covered. Prior authorization is required for these services, which do not require a prior three-day inpatient hospital stay for admission.
Other Services See details
UHC Dual Complete NC-D001 (HMO-POS D-SNP) partially covers other services, providing over-the-counter items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture and other miscellaneous services under this benefit category are not covered.
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