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UHC Dual Complete OH-V001 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete OH-V001 (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-V001 (HMO D-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete OH-V001 (HMO D-SNP) is a HMO D-SNP plan offered by Unitedhealthcare of Wisconsin, Inc. available for the 2026 plan year 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-V001 (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-V001 (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-V001 (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-V001 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5800.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $5800.00 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:
Sign up for UHC Dual Complete OH-V001 (HMO D-SNP)
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Drug Coverage
The UHC Dual Complete OH-V001 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, requiring no copay for 1-month and 3-month supplies at standard pharmacies or through standard mail order. For Tier 2 generic drugs, you will pay a 25% coinsurance for both 1-month and 3-month supplies. For Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the plan charges a consistent 25% coinsurance at standard pharmacies and standard mail order. This coinsurance applies to 1-month and 3-month supplies for Tier 3, and 1-month supplies for Tiers 4 and 5. Understanding these cost-sharing details helps you estimate your out-of-pocket prescription costs with this plan.
Additional Benefits
The UHC Dual Complete OH-V001 (HMO D-SNP) plan offers comprehensive medical coverage with highly affordable out-of-pocket costs, including no copay and no coinsurance for primary care, telehealth, and routine preventive services. Specialist visits feature low copays ranging from $0 to $30, while emergency services have a $130 copay that is waived if you are admitted to the hospital. Inpatient hospital stays require a $400 copay for the first several days of your stay, after which there is no copay. Additional benefits include routine dental, vision, and hearing services, which are largely covered with no copay and no coinsurance. Members also receive up to 24 one-way transportation trips per year and home health services at no cost. For specialized needs, dialysis and durable medical equipment are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Dual Complete OH-V001 (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $400 copay for days 1-7 of acute stays (with no copay for days 8 and beyond) and a $400 copay for days 1-5 of psychiatric stays (with no copay for days 6-90). Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete OH-V001 (HMO D-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of $0 to $400, while outpatient substance abuse services carry copays of $0 to $25, with prior authorization required for these benefits.
Partial Hospitalization See details
Partial hospitalization services are covered by UHC Dual Complete OH-V001 (HMO D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete OH-V001 (HMO D-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete OH-V001 (HMO 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 have a copay ranging from $0 to $50 with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC Dual Complete OH-V001 (HMO D-SNP) covers primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, mental health services, and physical therapy are also covered with no coinsurance and copays ranging from $0 to $30, while chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete OH-V001 (HMO D-SNP) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, home safety devices, in-home support, caregiver training, and kidney disease education. Covered screenings and exams, such as diabetes self-management and glaucoma screenings, also feature no copay and no coinsurance. Not covered services include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete OH-V001 (HMO D-SNP) with no copay and no coinsurance for routine exams and select hearing aids. While one routine hearing exam per year and up to two OTC or prescription hearing aids every two years are covered, fitting and evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
UHC Dual Complete OH-V001 (HMO D-SNP) offers partially covered vision services with no copay, no coinsurance, and no deductible. Covered benefits include one routine eye exam per year and eyewear options like contact lenses (up to $150 yearly) or one pair of eyeglasses, while other eye exams, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete OH-V001 (HMO D-SNP), with fixed prosthodontics excluded from coverage. Medicare-covered dental services require no copay and a 20% coinsurance, while other preventive, diagnostic, and comprehensive dental services are covered with no copay and no coinsurance.
Home Infusion bundled Services See details
UHC Dual Complete OH-V001 (HMO D-SNP) covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by the UHC Dual Complete OH-V001 (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Dual Complete OH-V001 (HMO D-SNP), featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, though manufacturer limits apply and prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete OH-V001 (HMO D-SNP) with prior authorization required. Diagnostic tests require a $50 copay with no coinsurance, while lab and diagnostic radiological services have no copay and no coinsurance. Outpatient x-rays require a $25 copay with coinsurance, and therapeutic radiological services require both a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the UHC Dual Complete OH-V001 (HMO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered by UHC Dual Complete OH-V001 (HMO D-SNP) with no copay, no coinsurance, and prior authorization required. However, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by UHC Dual Complete OH-V001 (HMO D-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete OH-V001 (HMO D-SNP) provides partial coverage for other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture and other miscellaneous services are not covered, and prior authorization is required for the meal benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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