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UHC Complete Care DE-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 DE-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 DE-4 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care DE-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 Delaware. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Complete Care DE-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 DE-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 DE-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 DE-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 $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 DE-4 (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, as well as no copay for a 3-month supply through preferred or standard mail order. Tier 2 generic medications require an $8 copay for a 1-month supply at standard pharmacies, but members can save with no copay for a 3-month supply ordered through preferred mail order. For higher-tier prescription medications, coverage costs transition to coinsurance percentages. Tier 3 preferred brand drugs carry a 20% coinsurance for both 1-month and 3-month supplies across standard pharmacies and mail-order options. Tier 4 non-preferred drugs require a 42% coinsurance, while Tier 5 specialty drugs carry a 28% coinsurance for a 1-month supply.
Additional Benefits
The UHC Complete Care DE-4 (HMO-POS C-SNP) plan offers robust coverage for everyday healthcare needs, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, specialist visits require a low copay of up to $30, while inpatient hospital stays have a daily copay of $350 for the first several days followed by no copay. Emergency services are covered with a $130 copay, which is waived upon admission, and urgent care visits range from no copay up to a $50 copay. Ancillary benefits include no-copay routine eye and hearing exams, alongside coverage for contacts, frames, and hearing aids with no coinsurance. While preventive dental care and diabetic supplies are available with no copay and no coinsurance, diagnostic services, dialysis, and durable medical equipment generally require a 20% coinsurance or set copayments. Additionally, members can benefit from covered over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, requiring a daily copay of $350 for days 1-7 of acute stays and days 1-6 of psychiatric stays, followed by no copay for subsequent days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by UHC Complete Care DE-4 (HMO-POS C-SNP) with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $350 (including $350 per day for observation services), while outpatient substance abuse services have a copay of $0 to $25 for individual sessions and $15 for group sessions.
Partial Hospitalization See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers ground and air ambulance services with a $290.00 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require 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 DE-4 (HMO-POS C-SNP) provides primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $0 to $30 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $30 copay and no coinsurance, but for chiropractic services, some services are covered though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the UHC Complete Care DE-4 (HMO-POS C-SNP) plan, featuring no copay and no coinsurance for covered services like annual physical exams, fitness benefits, and kidney disease education. However, several supplemental services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care DE-4 (HMO-POS C-SNP), which offers one routine hearing exam per year with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered up to two devices per year with no coinsurance and copays ranging from $199.00 to $1,249.00, but inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Complete Care DE-4 (HMO-POS C-SNP), featuring one routine eye exam per year with no copay and no coinsurance, though other eye exam services are not covered. Covered eyewear includes contact lenses and frames with no copay, and eyeglass lenses with a $0 to $153 copay, all with no coinsurance up to a $250 maximum every two years; upgrades and bundled eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by UHC Complete Care DE-4 (HMO-POS C-SNP), featuring Medicare-covered dental care with no copay and a 20% coinsurance, and preventive care with no copay and no coinsurance. Comprehensive dental benefits, including restorative services, endodontics, periodontics, prosthodontics, implants, and oral surgery, are not covered under this plan.
Home Infusion bundled Services See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis services are covered by UHC Complete Care DE-4 (HMO-POS C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care DE-4 (HMO-POS C-SNP), featuring no copay and 20% coinsurance for durable medical equipment and prosthetics. Diabetic equipment, supplies, and therapeutic shoes are covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services under the UHC Complete Care DE-4 (HMO-POS C-SNP) plan are covered with prior authorization. Lab services and diagnostic radiological services are available with no copay, while diagnostic procedures require a $50 copay with no coinsurance, outpatient X-rays require a $25 copay, and therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home health services are covered under the UHC Complete Care DE-4 (HMO-POS C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Complete Care DE-4 (HMO-POS C-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by UHC Complete Care DE-4 (HMO-POS C-SNP) with no coinsurance, as additional days beyond the Medicare-covered limit are not covered. Under this plan, there is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with prior authorization required and no prior three-day hospital stay needed.
Other Services See details
UHC Complete Care DE-4 (HMO-POS C-SNP) covers over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance, though the meal benefit requires prior authorization. Acupuncture and other additional services under this benefit are not covered.
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