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UHC Dual Complete OH-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 OH-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 OH-D001 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete OH-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 Ohio. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete OH-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 OH-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 OH-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 OH-D001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.30. 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 OH-D001 (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach that amount, you enter the next coverage phase. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS). With LIS, you'll pay $39.30 for Part D. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan offers a wide range of benefits. Inpatient hospital stays have a $1950 copay per admission, while outpatient services have a coinsurance between 0% and 20%. Emergency services have a $110 copay, and primary care services have a coinsurance between 0% and 20%. Preventive services include no copay annual physical exams, and other services with varying copays or coinsurance. Hearing services cover hearing exams and prescription hearing aids with no copay, and vision services offer no copay eye exams and eyewear. Dental services are covered with no copay for most services. The plan also covers home health services, medical equipment, and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, the copay is $1950 per admission or stay for a Medicare-covered stay, and there is no copay for additional days (91-999). Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered with coinsurance ranging from 0% to 20%. Observation Services are covered with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered with a coinsurance between 0% and 20%. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
The UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan covers ambulance and transportation services. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by the UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan. For emergency services, the copay is $110, and for urgently needed services, the copay is between $0 and $45; there is no coinsurance for either. Worldwide emergency services have a $0 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
The UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan covers primary care physician services with a coinsurance of 0% to 20%. Chiropractic services are partially covered with a 20% coinsurance, but routine care is not covered. Occupational therapy services have a coinsurance of 0% to 20%, and physician specialist services have a coinsurance of 0% to 20%. Mental health specialty services, including individual and group sessions, are covered with a coinsurance of 0% to 20%. Podiatry services are covered with a 20% coinsurance, and routine foot care is covered. Other healthcare professional services have a coinsurance of 0% to 20%. Psychiatric services are covered with a coinsurance of 0% to 20%. Physical therapy and speech-language pathology services have a coinsurance of 0% to 20%. Additional telehealth benefits have no copay. Opioid treatment program services have no copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional services. Additional preventive services have a copay, while other services like Glaucoma Screenings, 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
The UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, while fitting/evaluation for hearing aids is not covered. Prescription hearing aids are covered with no copay, up to a maximum of $3200 every year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay. Eyewear includes contact lenses, eyeglass lenses and eyeglass frames with no copay, and a combined maximum benefit of $450 every year.
Dental Services See details
Dental Services are covered, with Medicare Dental Services requiring prior authorization and a 20% coinsurance. Other Dental Services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, maxillofacial prosthetics, and prosthodontics (fixed) with no copay. Implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay with a coinsurance between 0-20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a coinsurance of at most 20%, lab services with no copay, diagnostic radiological services with a coinsurance of at most 20%, therapeutic radiological services with a coinsurance of at most 20%, and outpatient X-ray services with a coinsurance of at most 20%. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete OH-D001 (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 covered, but not in practice. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by UHC Dual Complete OH-D001 (HMO-POS D-SNP), but the additional days beyond Medicare-covered and non-Medicare-covered stays are not covered. The plan requires prior authorization and charges the Medicare-defined cost share for tier 1, with copay information available separately.
Other Services See details
The UHC Dual Complete OH-D001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) items and meal benefits with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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