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UHC Dual Complete OH-D001 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete OH-D001 (HMO 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 OH-D001 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete OH-D001 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Ohio. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete OH-D001 (HMO 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 OH-D001 (HMO 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 OH-D001 (HMO 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 OH-D001 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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 $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 OH-D001 (HMO D-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies, as well as for a 3-month supply via standard mail order. This makes starting and maintaining your essential generic medications highly affordable. For other drug tiers, the plan utilizes a consistent cost-sharing model. Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs all require a 25% coinsurance at standard pharmacies and standard mail order. This coinsurance applies to 1-month and 3-month supplies for Tier 2 and Tier 3, and 1-month supplies for Tier 4 and Tier 5.
Additional Benefits
The UHC Dual Complete OH-D001 (HMO D-SNP) plan offers comprehensive medical coverage with no copays for primary care, specialist visits, telehealth, and outpatient hospital services, though an outpatient coinsurance of up to 20% may apply. Emergency room visits require a $115 copay, which is waived if admitted, while inpatient hospital stays carry a copay of $2,230 per acute stay or $2,080 per psychiatric stay with no coinsurance. Additionally, ground and air ambulance services require a 20% coinsurance, while routine transportation is covered with no copay or coinsurance for up to 36 one-way trips annually. Members benefit from key supplemental services, including routine dental, vision exams, eyewear up to $150 annually, and prescription hearing aids with no copays or coinsurance. Valuable support services like home health care, skilled nursing facility stays, and over-the-counter items are also covered with no copays and no coinsurance. Other essential services, including dialysis, durable medical equipment, and diagnostic tests, are available with no copays and a 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered under UHC Dual Complete OH-D001 (HMO D-SNP) with no coinsurance, requiring prior authorization and a copay of $2,230 per acute stay or $2,080 per psychiatric stay. Unlimited additional acute days are covered with no copay, but non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete OH-D001 (HMO D-SNP) covers outpatient services with no copays, though a coinsurance of 0% to 20% applies to most services. Covered benefits include outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, most of which require prior authorization.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Dual Complete OH-D001 (HMO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under UHC Dual Complete OH-D001 (HMO D-SNP) cover ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation is partially covered with no copay and no coinsurance, offering up to 36 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 OH-D001 (HMO D-SNP) emergency services are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours and does not count toward a deductible. Urgently needed services require a copay of $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 OH-D001 (HMO D-SNP) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while chiropractic services are not covered. Therapy and mental health services also feature no copay with coinsurance up to 20%, and telehealth benefits are available with no copay and no coinsurance.
Preventive Services See details
Preventive services for UHC Dual Complete OH-D001 (HMO D-SNP) are partially covered, offering annual physical exams, kidney disease education, and fitness benefits with no copay and no coinsurance. While digital rectal exams and post-welcome visit EKGs require a 20% coinsurance, several services are not covered, including health education, personal emergency response systems, medical nutrition therapy, and alternative therapies.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete OH-D001 (HMO D-SNP), which provides one routine hearing exam per year with a 20% coinsurance and no copay, while fitting and evaluation exams are not covered. Additionally, up to two prescription or OTC hearing aids are covered every two years with no copay and no coinsurance, though inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete OH-D001 (HMO D-SNP) with no deductible, no copay, and no coinsurance for covered benefits, including one routine eye exam and eyeglasses (lenses and frames) or contact lenses up to $150 annually. Other eye exam services, eyeglass lenses, and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete OH-D001 (HMO D-SNP), with fixed prosthodontics being the only excluded service. Medicare-covered dental services are available with no copay and a 20% coinsurance, while all other covered preventive and comprehensive dental services require no copay and no coinsurance.
Home Infusion bundled Services See details
UHC Dual Complete OH-D001 (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OH-D001 (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete OH-D001 (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic services with no copays and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete OH-D001 (HMO D-SNP) with prior authorization required. Lab services feature no copay, diagnostic radiological services have no copay and no coinsurance, and other services like outpatient x-rays, therapeutic radiology, and diagnostic tests require a 20% coinsurance and applicable copays.
Home Health Services See details
UHC Dual Complete OH-D001 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete OH-D001 (HMO D-SNP) offers cardiac rehabilitation services with no copay and prior authorization, though only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete OH-D001 (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered because additional days beyond the Medicare-covered limit are not covered, though the plan does allow for admission without a prior three-day inpatient hospital stay.
Other Services See details
Other services are partially covered by UHC Dual Complete OH-D001 (HMO D-SNP), featuring over-the-counter (OTC) items and chronic-illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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