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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 2025, 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 Select Counties in North Carolina. This plan received an overall rating of 4 out of 5 stars in 2025.
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 $51.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. 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 combined Maximum Out-Of-Pocket cost of $4500.00 (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 $4500.00 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) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D will be $51.20. During the initial coverage phase, after meeting your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach $2000 in out-of-pocket drug costs, you enter the catastrophic coverage phase.
Additional Benefits
The UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and some primary care services have no copay. The plan also covers ambulance services, emergency services, and many preventive services with no copay. This plan also provides coverage for hearing and vision services, with no copays for exams and eyewear. Dental, home infusion, and medical equipment services are covered, but may have coinsurance. Additionally, the plan offers benefits like OTC items and meal benefits with no copay, as well as transportation to health-related locations.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $395 for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute, and a copay of $395 for days 1-5, and no copay for days 6-90 for Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute are covered with no copay for days 91-999. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services with a copay between $0 and $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services and outpatient blood services have no copay, and outpatient substance abuse services include individual sessions with a copay between $0 and $25, and group sessions with a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including Ground and Air Ambulance Services, with a copay of $275.00 each, but no coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay and no coinsurance, up to 24 one-way trips per year via taxi or medical transport. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay with no coinsurance, and the copay is waived if you are admitted to the hospital within 24 hours; Urgently Needed Services have a copay between $0 and $55 with no coinsurance; and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered under the Primary Care benefit. Primary Care Physician Services have no copay, Chiropractic Services have a $20 copay, Occupational Therapy Services have a copay between $0 and $15, Physician Specialist Services have a copay between $0 and $15, Mental Health Specialty Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, Podiatry Services and Other Health Care Professional have a copay between $15 and $15, Psychiatric Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $15, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered zero-dollar services and an annual physical exam with no copay. Additional preventive services, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, are covered with no copay. Some additional services, such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, and others are not covered.
Hearing Services See details
Hearing Services include hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829, while Fitting/Evaluation for Hearing Aid, and Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered. Prescription hearing aids (all types) have a copay between $199 and $1249.
Vision Services See details
The UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan covers vision services, including eye exams with no copay, and eyewear with no copay. Contact lenses and eyeglass frames are covered with no copay, while eyeglass lenses have a copay of $0-$153. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, with 20% coinsurance for Medicare Dental Services, and Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services all covered with no copay. Orthodontic, Restorative, Adjunctive General, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Other Medicare Part B Drugs, and Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered with prior authorization, and the coinsurance is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while DME for use outside the home is not covered. Prosthetic devices and medical supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a copay of $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $205, and Outpatient X-Ray Services have a copay of $15. Therapeutic Radiological Services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete NC-V001 (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 the plan does not specify the copay or coinsurance. However, 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 the UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, while days 21-100 have a $203 copay, and additional days beyond Medicare-covered stays and non-Medicare-covered stays are not covered.
Other Services See details
The UHC Dual Complete NC-V001 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits with no copay, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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