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UHC Complete Care RI-4 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care RI-4 (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 RI-4 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care RI-4 (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 State of Rhode Island. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Complete Care RI-4 (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 RI-4 (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 RI-4 (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 RI-4 (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 $355.00 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 $4900.00 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 RI-4 (HMO-POS C-SNP) Medicare plan features an annual drug deductible of $355. Under this plan, you will benefit from no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a standard pharmacy or standard mail order. Specifically, standard pharmacies offer no copay on one-month and three-month supplies of these generic medications. For brand-name and specialty medications, costs are structured around coinsurance percentages rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance for standard pharmacy and mail order fills, while Tier 4 non-preferred drugs carry a 42% coinsurance for a one-month supply. Specialty Tier 5 medications are covered with a 29% coinsurance for a one-month supply through standard pharmacies and mail order.
Additional Benefits
The UHC Complete Care RI-4 (HMO-POS C-SNP) plan offers comprehensive healthcare coverage with no copay and no coinsurance for primary care, telehealth, and preventive services. For inpatient hospital stays, members pay no coinsurance and a $345 daily copay for the first six days, followed by no copay for days 7 through 90. Outpatient hospital services, emergency care, and specialist visits are also covered with manageable copays and no coinsurance. Supplemental benefits include routine dental, vision, and hearing exams with no copay, as well as allowances for eyewear, hearing aids, and over-the-counter items. Additionally, the plan features no copay for up to 24 one-way transportation trips per year and no copay or coinsurance for diabetic equipment. Other services, such as durable medical equipment and dialysis, require no copay and a 20% coinsurance.
Inpatient Hospital See details
UHC Complete Care RI-4 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a $345 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and while unlimited additional acute stay days are covered at no copay, additional psychiatric days beyond 90 are not covered.
Outpatient Services See details
UHC Complete Care RI-4 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $345 for outpatient hospital and observation services, and no copay for ambulatory surgical center and blood services. Outpatient substance abuse services also have no coinsurance, with copays of $0 to $25 for individual sessions and a $15 copay for group sessions. Prior authorization is required for these outpatient services, which also feature no deductible for blood services.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Complete Care RI-4 (HMO-POS C-SNP) plan with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Complete Care RI-4 (HMO-POS C-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 or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Complete Care RI-4 (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care and telehealth services are covered under the UHC Complete Care RI-4 (HMO-POS C-SNP) plan with no copay and no coinsurance. Specialist visits, therapy services, podiatry, and mental health care are covered with copays up to $25 and no coinsurance, though chiropractic benefits are only partially covered as routine care is excluded.
Preventive Services See details
Preventive services are covered by UHC Complete Care RI-4 (HMO-POS C-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, fitness benefits, and home safety devices. However, additional preventive benefits are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered under UHC Complete Care RI-4 (HMO-POS C-SNP), offering one annual routine hearing exam with no copay and no coinsurance, though fitting and evaluation exams are not covered. While some prescription hearing aid services are covered with a copay of $199.00 to $1,249.00 and no coinsurance, inner ear, outer ear, and over the ear models are not covered. OTC hearing aids are covered up to two per year with a $199.00 to $829.00 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by UHC Complete Care RI-4 (HMO-POS C-SNP), offering routine eye exams and contact lenses with no copay and no coinsurance, plus eyeglass frames and lenses with no coinsurance and copays from $0 to $153 up to a $300 allowance every two years. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under UHC Complete Care RI-4 (HMO-POS C-SNP), excluding implant services and orthodontics. Preventive and diagnostic services feature no copay and no coinsurance up to a $5,000 annual limit, while comprehensive services require no copay and 50% coinsurance, and Medicare-covered dental services have no copay and 20% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Complete Care RI-4 (HMO-POS C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care RI-4 (HMO-POS C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered under the UHC Complete Care RI-4 (HMO-POS C-SNP) plan, featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic equipment and supplies are also covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Complete Care RI-4 (HMO-POS C-SNP) with prior authorization required. Diagnostic tests require a $30 copay and lab services have no copay, both with no coinsurance, while diagnostic radiological services have no copay, outpatient X-rays require a $25 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered under the UHC Complete Care RI-4 (HMO-POS C-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by UHC Complete Care RI-4 (HMO-POS C-SNP) with no copay and no coinsurance, but prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care RI-4 (HMO-POS C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by UHC Complete Care RI-4 (HMO-POS C-SNP), featuring over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture and other additional services under this category are not covered.
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