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UHC Complete Care IA-5 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care IA-5 (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 IA-5 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care IA-5 (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 Iowa and Illinois. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Complete Care IA-5 (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 IA-5 (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 IA-5 (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 IA-5 (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 $420.00 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 $3900.00 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 IA-5 (HMO-POS C-SNP) plan has an enhanced alternative drug benefit. The plan has a deductible of $420.00. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $10.00 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2000.00, you will enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The UHC Complete Care IA-5 (HMO-POS C-SNP) plan offers a variety of benefits with varying costs. This plan covers inpatient hospital stays with a copay, and outpatient services with copays ranging from $0 to $475. It also includes no copay for primary care, preventive services, vision services, and many dental services. Additional benefits include hearing services with copays for hearing aids, and ambulance services with a $290 copay. The plan also covers home health services, skilled nursing facilities, and diagnostic services with various copays and coinsurance, and covers home infusion bundled services with a copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $475 copay for days 1-6, and no copay for days 7-90, with additional days 91-999 at no copay; Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital Psychiatric, you'll pay a $475 copay for days 1-5, and no copay for days 6-90; Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay ranging from $0 to $475, observation services with a $475 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services, including individual and group sessions, have no copay, and outpatient blood services also have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care IA-5 (HMO-POS C-SNP) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Complete Care IA-5 (HMO-POS C-SNP) plan. Ground and Air Ambulance Services have a $290 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by UHC Complete Care IA-5 (HMO-POS C-SNP). Emergency services have a $140 copay, while urgently needed services have a copay between $0 and $65, and worldwide emergency services have a copay depending on the service.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay, but routine care is not covered. Occupational Therapy Services are covered with a copay between $0 and $25. Physician Specialist Services are covered with no copay. Mental Health Specialty Services are covered with no copay for individual and group sessions. Podiatry Services are covered with a $30 copay for Medicare-covered services and routine foot care, up to 6 visits per year. Other Health Care Professional services are covered with a copay between $0 and $30. Psychiatric Services are covered with no copay for individual and group sessions. Physical Therapy and Speech-Language Pathology Services are covered with a copay between $0 and $25. Additional Telehealth Benefits have no copay. Opioid Treatment Program Services are covered with no copay.
Preventive Services See details
The UHC Complete Care IA-5 (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing Services include hearing exams, prescription hearing aids, and OTC hearing aids. Routine hearing exams have no copay, and are limited to one per year. Prescription hearing aids have a copay between $199 and $1249 for all types, and are limited to two per year. OTC hearing aids have a copay between $99 and $829, and are limited to two per year. Fitting/Evaluation for Hearing Aid, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
The UHC Complete Care IA-5 (HMO-POS C-SNP) plan covers vision services including eye exams, routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames with no copay. Eyeglass frames are limited to 1 every two years, while eyeglass lenses have a copay from $0-$153. Eyewear has a combined maximum benefit of $250 every two years, and upgrades are not covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and also cover Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatments, and Other Preventive Dental Services, all with no copay. Other Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, you will pay a $35 copay. For all covered services, you may pay between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered with prior authorization, and have a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment; Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The UHC Complete Care IA-5 (HMO-POS C-SNP) plan covers diagnostic and radiological services, including diagnostic procedures/tests with a $50 copay, lab services with no copay, diagnostic radiological services with a copay up to $250, therapeutic radiological services with a coinsurance of at least 20%, and outpatient X-ray services with a $25 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care IA-5 (HMO-POS C-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
UHC Complete Care IA-5 (HMO-POS C-SNP) does not cover Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day; there is no coinsurance. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and a Meal Benefit. The OTC benefit has no copay, while the meal benefit also has no copay and requires prior authorization. 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.
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