A non-government entity
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 2025, 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 2025.
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 $340.00 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 $5200.00 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:
Sign up for UHC Complete Care MA-7 (HMO-POS C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Complete Care MA-7 (HMO-POS C-SNP) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance for your prescriptions. For generic drugs, you will pay a $12 copay at a standard pharmacy for tier 1 drugs, and a $47 copay for tier 2 drugs. For preferred brand drugs, you will pay a $100 copay, and for non-preferred drugs, you will pay 29% coinsurance.
Additional Benefits
The UHC Complete Care MA-7 (HMO-POS C-SNP) plan offers a range of benefits. This plan includes no copay for primary care, preventive services, home health services, vision eye exams, and dental oral exams and x-rays. It also offers no copay for OTC items and no coinsurance for meal benefits. The plan has copays for inpatient hospital stays, outpatient services, specialist visits, and various therapies. You will also have copays for ambulance and emergency services. Hearing, vision, dental, and medical equipment services are also available.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the UHC Complete Care MA-7 (HMO-POS C-SNP) plan. For days 1-5, there is a $395 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services have no copay, while Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25 and Group Sessions have a $15 copay. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care MA-7 (HMO-POS C-SNP) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $275 copay for both ground and air ambulance services and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed and worldwide emergency services, are covered. Emergency services have a $125 copay, while urgently needed services have a copay between $0 and $55; there is no coinsurance for either. Worldwide emergency services have no copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation.
Primary Care See details
The UHC Complete Care MA-7 (HMO-POS C-SNP) plan covers primary care physician services with no copay, while chiropractic services have a $20 copay. Occupational therapy services have a copay between $0 and $20, and physician specialist services have a copay between $0 and $25. Mental health specialty services and psychiatric services have a copay of $0-$25 for individual sessions and $15 for group sessions. Podiatry services and other health care professional services have a $25 copay. Physical therapy and speech-language pathology services have a copay between $0 and $20, and additional telehealth benefits have no copay. Opioid treatment program services also have no copay.
Preventive Services See details
The UHC Complete Care MA-7 (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, but some services like health education and in-home safety assessments are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but routine hearing exams are limited to one per year and fitting/evaluation for hearing aids are not covered. Prescription hearing aids are covered, with a copay between $199 and $1249 for all types and two hearing aids per year, but inner, outer, and over-the-ear hearing aids are not covered. OTC hearing aids are covered with a copay between $99 and $829, with a limit of two hearing aids per year.
Vision Services See details
Vision services include eye exams and eyewear, with routine eye exams and eyewear benefits covered. Eye exams have no copay. Contact lenses and eyeglass frames have no copay, while eyeglass lenses have a copay between $0 and $153, and the plan offers a combined maximum benefit of $250 for all eyewear every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with 20% coinsurance, oral exams, and dental x-rays with no copay, as well as prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Orthodontic, restorative, adjunctive general, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics services 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), including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the UHC Complete Care MA-7 (HMO-POS C-SNP) plan. This plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered, with a $50 copay for diagnostic procedures and tests and a $0 copay for lab services. Diagnostic radiological services have a copay of up to $250, therapeutic radiological services have a coinsurance of up to 20%, and outpatient X-ray services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care MA-7 (HMO-POS C-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the UHC Complete Care MA-7 (HMO-POS C-SNP) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Complete Care MA-7 (HMO-POS C-SNP) plan, but require prior authorization. For days 1-20, there is no copay, while days 21-100 have a $203 copay. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefits, with no copay for OTC items and no coinsurance for either. 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved