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UHC Dual Complete NC-V001 (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-V001 (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-V001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NC-V001 (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 State of 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-V001 (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-V001 (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-V001 (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-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.20. 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 combined Maximum Out-Of-Pocket cost of $5900.00 (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 $5900.00 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-V001 (HMO-POS D-SNP) Medicare plan features an annual prescription drug deductible of $615. For those looking to save on common medications, Tier 1 preferred generic drugs offer no copay for 1-month and 3-month fills at standard pharmacies or through standard mail order. For other drug categories, including Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, members will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy and standard mail order options during the initial coverage phase.
Additional Benefits
The UHC Dual Complete NC-V001 (HMO-POS D-SNP) offers comprehensive coverage with no copay and no coinsurance for primary care, telehealth, preventive services, and home health care. For specialized medical needs, members pay no coinsurance but face predictable copays, such as $0 to $30 for specialist visits and a $450 daily copay for the first few days of inpatient hospital stays. Emergency care is accessible with a $130 copay that is waived upon admission, while worldwide emergency services and urgent care feature no copay. Ancillary benefits include no copay for routine dental, vision, and hearing exams, though prescription hearing aids and eyeglass lenses require moderate copays. Durable medical equipment, dialysis, and Medicare-covered dental services carry a 20% coinsurance with no copay. Additionally, the plan provides valuable extras like over-the-counter items, chronic illness meals, and up to 24 one-way transportation trips per year with no copay.
Inpatient Hospital See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers inpatient hospital services with no coinsurance, requiring prior authorization and a daily copay of $450 for days 1 through 6 of acute stays (no copay for days 7 and beyond) and days 1 through 5 of psychiatric stays (no copay for days 6 through 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $450, observation services carry a $450 daily copay, and outpatient substance abuse sessions have copays ranging from no copay to $25.
Partial Hospitalization See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copayment and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance. Transportation benefits are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but trips to any health-related location are not covered.
Emergency Services See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay to $50 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 NC-V001 (HMO-POS D-SNP) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits, physical therapy, mental health, and podiatry services are also covered with copays ranging from $0 to $30 and no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers preventive services, such as annual exams, kidney education, and diabetes training, with no copay and no coinsurance. Additional preventive benefits are partially covered, including fitness, weight management, caregiver support, and home safety devices, while excluded sub-services include health education, nutritional therapy, personal emergency response systems (PERS), alternative therapies, and telemonitoring.
Hearing Services See details
Hearing Services are partially covered by UHC Dual Complete NC-V001 (HMO-POS D-SNP), offering one routine hearing exam per year with no copay and no coinsurance, while fitting and evaluation services are not covered. Prescription hearing aids are covered with a $199 to $1,249 copay and no coinsurance, and OTC hearing aids are covered with a $199 to $829 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 NC-V001 (HMO-POS D-SNP), featuring no copay or coinsurance for annual routine eye exams, contact lenses, and eyeglass frames, alongside eyeglass lenses with a $0 to $153 copay and no coinsurance. While a $200 maximum benefit is provided every two years for eyewear, other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete NC-V001 (HMO-POS D-SNP), with Medicare-covered dental care requiring no copay and a 20% coinsurance, and preventive services like cleanings, exams, fluoride, and x-rays available with no copay and no coinsurance. However, other diagnostic, restorative, endodontic, periodontic, prosthodontic, oral surgery, implant, orthodontic, maxillofacial prosthetics, and adjunctive general dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete NC-V001 (HMO-POS D-SNP) with no copay and no coinsurance, subject to prior authorization. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers medical equipment with no copays, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay from specified manufacturers, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete NC-V001 (HMO-POS D-SNP) with prior authorization required. Lab services and diagnostic radiology are offered with no copay and no coinsurance, while diagnostic tests require a $40 copay with no coinsurance, outpatient X-rays require a $25 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under UHC Dual Complete NC-V001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. Some services are covered, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete NC-V001 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with additional days beyond the Medicare-covered limit not covered.
Other Services See details
Other services under UHC Dual Complete NC-V001 (HMO-POS D-SNP) are partially covered, featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other additional services are not covered under this plan, and the meal benefit requires prior authorization.
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