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UHC Complete Care MA-7 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care MA-7 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care MA-7 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care MA-7 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Massachusetts. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Complete Care MA-7 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care MA-7 (HMO-POS C-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 Complete Care MA-7 (HMO-POS C-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 Complete Care MA-7 (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $440.00 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 $5900.00 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 Complete Care MA-7 (HMO-POS C-SNP) prescription drug plan features an annual drug deductible of $440. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and mail-order services. Tier 2 generic drugs cost a $12 copay for a 1-month supply at standard pharmacies, though a 3-month supply has no copay when filled through preferred mail order. Tier 3 preferred brand drugs require a 20% coinsurance at standard pharmacies and for mail-order services. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 36% coinsurance and Tier 5 specialty drugs carry a 28% coinsurance for a 1-month supply. These details outline the primary out-of-pocket drug costs for beneficiaries considering this Medicare plan.
Additional Benefits
The UHC Complete Care MA-7 (HMO-POS C-SNP) plan offers comprehensive coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, members pay no coinsurance and low copays, such as $0 to $35 for specialist visits and a $130 copay for emergency room visits. Inpatient hospital stays require a $450 daily copay for the first 5 to 6 days with no coinsurance, after which there is no copay for the remaining covered days. This plan also includes valuable supplemental benefits, such as no copay for routine eye and hearing exams, alongside a $200 eyewear allowance and affordable copays for hearing aids. Preventive dental care is fully covered with no copay or coinsurance, while durable medical equipment and dialysis services require no copay and a 20% coinsurance. Additionally, members benefit from no copay for over-the-counter items, diabetic supplies, and home infusion services.
Inpatient Hospital See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, featuring a $450 copay per day for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, followed by no copay for remaining covered days. Prior authorization is required, and certain services like upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers outpatient services with no coinsurance, although prior authorization is required. Patients will pay a copay of $0 to $450 for outpatient hospital and observation services, a copay of $0 to $25 for outpatient substance abuse services, and no copay for ambulatory surgical center and blood services.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Complete Care MA-7 (HMO-POS C-SNP) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by UHC Complete Care MA-7 (HMO-POS C-SNP) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature 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 Complete Care MA-7 (HMO-POS C-SNP) provides primary care, telehealth, and opioid treatment services with no copay and no coinsurance. Specialist visits, mental health, podiatry, and therapy services are covered with no coinsurance and copays ranging from $0 to $35, while some chiropractic services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Complete Care MA-7 (HMO-POS C-SNP) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, home safety devices, and kidney disease education. However, the plan does not cover health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) offers partially covered hearing services, including one annual routine hearing exam with no copay and no coinsurance, while fitting and evaluation services are not covered. Prescription hearing aids are covered with a $199.00 to $1,249.00 copay and no coinsurance, excluding inner ear, outer ear, and over the ear types, and OTC hearing aids are covered with a $199.00 to $829.00 copay and no coinsurance.
Vision Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) provides partially covered vision services with no coinsurance, including no copay for annual routine eye exams and a $200 eyewear allowance every two years for contact lenses and frames. Eyeglass lenses are covered with no coinsurance and a copay of $0.00 to $153.00, while other eye exams, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by UHC Complete Care MA-7 (HMO-POS C-SNP), featuring Medicare-covered dental with no copay and a 20% coinsurance, and preventive care—such as exams, cleanings, and x-rays—with no copay and no coinsurance. However, major services including restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by UHC Complete Care MA-7 (HMO-POS C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and other covered drugs, have no coinsurance to 20% coinsurance, while Medicare Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic equipment and supplies are also covered with no copay and no coinsurance, though prior authorization is required and brand limitations apply.
Diagnostic and Radiological Services See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers diagnostic and radiological services with no copay and no coinsurance for lab services and diagnostic radiology. Diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays require a $25 copay, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Complete Care MA-7 (HMO-POS C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Complete Care MA-7 (HMO-POS C-SNP) plan, as all associated sub-services, including intensive cardiac and pulmonary rehabilitation, are not covered. Consequently, there are no copayments or coinsurance costs for these services under this plan.
Skilled Nursing Facility (SNF) See details
UHC Complete Care MA-7 (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior 3-day inpatient hospital stay, though prior authorization is required. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Complete Care MA-7 (HMO-POS C-SNP), offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this benefit, and prior authorization is required for the meal benefit.
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