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UHC Complete Care KY-6 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care KY-6 (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 KY-6 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care KY-6 (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 Kentucky. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Complete Care KY-6 (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 KY-6 (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 KY-6 (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 KY-6 (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 $6700.00 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 KY-6 (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. The plan offers different costs based on the drug tier and pharmacy type. For example, if you get a preferred generic drug at a standard pharmacy, you'll pay a $10 copay. If you reach $2000 in total drug costs, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs.
Additional Benefits
The UHC Complete Care KY-6 (HMO-POS C-SNP) plan offers comprehensive coverage including inpatient and outpatient hospital services, with varying copays. You'll have no copay for primary care, preventive services, routine vision and hearing exams, and many dental services. The plan also covers emergency services, ambulance, and skilled nursing facility stays, along with home health services. Additional benefits include coverage for hearing aids, eyeglasses, and certain medical equipment, with specific copays or coinsurance. The plan also provides coverage for diagnostic and radiological services, home infusion, and dialysis services. Some services require prior authorization, and there are exclusions for certain services like orthodontic and some dental procedures.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For days 1-5, there is a $445 copay, and for days 6-90, there is no copay; additional days 91-999 have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay of $0-$445, observation services with a copay of $445 per day, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a copay of $0-$25 for individual sessions and $15 for group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care KY-6 (HMO-POS C-SNP) plan and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground and air ambulance services each have a $275 copay, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Complete Care KY-6 (HMO-POS C-SNP) plan. Emergency services have a $125 copay, while urgently needed services have a copay between $0 and $55; all other services have no copay and no coinsurance.
Primary Care See details
The UHC Complete Care KY-6 (HMO-POS C-SNP) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a copay between $0 and $20, and physician specialist services with a copay between $0 and $25. The plan also covers mental health specialty services, podiatry services with a $25 copay, other health care professional services with a copay between $0 and $25, psychiatric services, physical therapy and speech-language pathology services with a copay between $0 and $20, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services. Additional services include Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, limited to one exam per year, and routine hearing exams are covered with no copay. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids per year, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, prescription hearing aids (inner ear, outer ear, and over the ear) are not covered.
Vision Services See details
The UHC Complete Care KY-6 (HMO-POS C-SNP) plan covers vision services including routine eye exams with no copay, and eyewear benefits including contact lenses, eyeglass lenses, and eyeglass frames. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The UHC Complete Care KY-6 (HMO-POS C-SNP) plan covers Medicare Dental Services with a 20% coinsurance, and other dental services including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B insulin drugs, there is a $35 copay and the coinsurance is between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care KY-6 (HMO-POS C-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The UHC Complete Care KY-6 (HMO-POS C-SNP) plan covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic supplies and therapeutic shoes/inserts have no copay, and DME for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for all diagnostic services, diagnostic procedures/tests, lab services, and radiological services. Diagnostic Procedures/Tests have a $50 copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $200, and Therapeutic Radiological Services have 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care KY-6 (HMO-POS C-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for certain Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the UHC Complete Care KY-6 (HMO-POS C-SNP) plan. You will have no copay for days 1-20, and a $203 copay per day for days 21-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the "Other Services" benefit, 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. Over-the-Counter (OTC) Items are covered with no copay, and Meal Benefits are covered with no copay, but require prior authorization.
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