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UHC Dual Complete NC-S3 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete NC-S3 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Dual Complete NC-S3 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete NC-S3 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of North Carolina. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Dual Complete NC-S3 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Dual Complete NC-S3 (HMO-POS D-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 Dual Complete NC-S3 (HMO-POS D-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 Dual Complete NC-S3 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.20. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. You must continue to pay paying your reduced 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 $615.00 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 combined Maximum Out-Of-Pocket cost of $9250.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9250.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Dual Complete NC-S3 (HMO-POS D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members benefit from no copay for 1-month and 3-month supplies at standard pharmacies, as well as 3-month standard mail orders. This makes starting and maintaining basic generic prescriptions highly affordable. For other medication categories, the plan charges a 25% coinsurance for standard pharmacy and standard mail order fills. This 25% coinsurance rate applies to Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs. Coverage is available in 1-month or 3-month supplies depending on the drug tier and how you choose to fill your prescription.
Additional Benefits
The UHC Dual Complete NC-S3 (HMO-POS D-SNP) plan offers comprehensive medical coverage, including inpatient hospital stays with a $1,765 copay and no copay for skilled nursing facility or home health services. Outpatient care, primary care visits, and specialist consultations generally feature no copay, with coinsurance ranging up to 20% depending on the service. Emergency services are available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides robust supplemental benefits, including up to $3,000 annually for dental care and a $300 yearly allowance for eyewear with no copay or coinsurance. Additionally, members benefit from hearing aid coverage up to $2,200 every two years, up to 48 one-way routine transportation trips, and no copay for over-the-counter items. Diagnostic services, dialysis, and durable medical equipment are also covered, typically requiring a 20% coinsurance and no copay.
Inpatient Hospital See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) partially covers inpatient hospital services with a $1,765 copay per stay and no coinsurance, though prior authorization is required. Unlimited additional days for acute care are covered with no copay, but upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) covers outpatient services with no copay, with coinsurance ranging from no coinsurance up to 20% depending on the specific service. Prior authorization is required for outpatient hospital, ambulatory surgical center, substance abuse, and blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under UHC Dual Complete NC-S3 (HMO-POS D-SNP), featuring a 20% coinsurance and no copay for both ground and air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered under the UHC Dual Complete NC-S3 (HMO-POS D-SNP) plan with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) covers primary care, specialist, therapy, and mental health services with no copay and 0% to 20% coinsurance, while chiropractic services are not covered. Telehealth and opioid treatment services are also covered with no copay and no coinsurance.
Preventive Services See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) provides partially covered preventive services, featuring no copays and no coinsurance for annual physicals, fitness benefits, caregiver support, and diabetes training, though digital rectal exams and post-welcome visit EKGs require a 20% coinsurance. Sub-services such as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP), offering routine hearing exams with no copay and a 20% coinsurance, while fitting and evaluation exams are not covered. Prescription hearing aids are covered up to $2,200 every two years with no copay and no coinsurance, though inner ear, outer ear, and over the ear types are not covered. OTC hearing aids are also covered with no copay and no coinsurance for up to two devices every two years.
Vision Services See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) partially covers vision services with no copay and no coinsurance, offering one routine eye exam per year and up to a $300 annual limit for contact lenses, eyeglass lenses, and frames. Other eye exams, upgrades, and eyeglasses (lenses and frames) are not covered.
Dental Services See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) partially covers dental services with an annual maximum benefit of $3,000, offering no copay and no coinsurance for most preventive and comprehensive dental care. Medicare-covered dental services require a 20% coinsurance and no copay, and while many restorative and surgical treatments are covered with prior authorization, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and ranges from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete NC-S3 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay from specified manufacturers, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization needed for most services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP) with prior authorization required. Diagnostic tests require a copay and a minimum 20% coinsurance, lab services require coinsurance with no copay, and radiological services feature no copays, with no coinsurance for diagnostic radiology and a minimum 20% coinsurance for therapeutic and X-ray services.
Home Health Services See details
Home Health Services are covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete NC-S3 (HMO-POS D-SNP) covers some services under its Cardiac Rehabilitation Services benefit with no copay, though prior authorization is required. However, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by UHC Dual Complete NC-S3 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the UHC Dual Complete NC-S3 (HMO-POS D-SNP) plan are partially covered, as acupuncture is not covered. Covered benefits include over-the-counter (OTC) items and chronic illness meal benefits, both of which are offered with no copay and no coinsurance.
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