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UHC Complete Care OH-18 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care OH-18 (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 OH-18 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care OH-18 (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 Ohio and 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 OH-18 (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 OH-18 (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 OH-18 (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 OH-18 (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 OH-18 (HMO-POS C-SNP) plan has a $340 deductible for prescription drugs. During the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you'll pay a $12 copay for a standard generic drug at a standard pharmacy, or 29% coinsurance for a non-preferred drug. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care OH-18 (HMO-POS C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays between $0 and $415, while outpatient services range from no copay to a $415 copay. Emergency services have a $125 copay, and primary care visits are covered with no copay for many services, but copays apply for some specialist visits. This plan also includes coverage for preventive, hearing, vision, and dental services. Hearing exams and routine eye exams have no copay, and eyewear has no copay. Dental services have no copay for some services, but coinsurance applies. Additional benefits include home health services with no copay, and coverage for medical equipment, dialysis, and home infusion services, with copays or coinsurance for some services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $415 copay for days 1-5, and no copay for days 6-90, while additional days 91-999 have no copay; non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric has a $415 copay for days 1-4, and no copay for days 5-90; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $415, Observation Services have a copay of $415, Ambulatory Surgical Center (ASC) Services have no copay, Individual Sessions for Outpatient Substance Abuse have a copay between $0 and $25, Group Sessions for Outpatient Substance Abuse have a copay of $15, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care OH-18 (HMO-POS C-SNP) plan, but requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Complete Care OH-18 (HMO-POS C-SNP) plan. Medicare-covered ground and air ambulance services have a $275 copay, with 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 OH-18 (HMO-POS C-SNP) plan. Emergency Services has a $125 copay, while Urgently Needed Services has a copay between $0 and $55. Worldwide Emergency Services has no copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The UHC Complete Care OH-18 (HMO-POS C-SNP) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $0-$20 copay, Physician Specialist Services with a $0-$25 copay, and Mental Health Specialty Services with a $0-$25 copay for individual sessions and a $15 copay for group sessions. This plan also covers Podiatry Services with a $25 copay, Other Health Care Professional services with a $0-$25 copay, Psychiatric Services with a $0-$25 copay for individual sessions and a $15 copay for group sessions, Physical Therapy and Speech-Language Pathology Services with a $0-$20 copay, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay.
Preventive Services See details
The UHC Complete Care OH-18 (HMO-POS C-SNP) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including fitness benefits, and home and bathroom safety devices and modifications, are covered with a copay. Kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit are covered with no copay. Other services such as health education, in-home safety assessments, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered with no copay for one exam per year. Prescription hearing aids are covered, with a copay between $199 and $1249 for two hearing aids per year, but fitting and evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $99 and $829 for two hearing aids per year.
Vision Services See details
Vision services include routine eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Eyeglass lenses have a copay of $0 - $153, and eyeglass frames have no copay. Contact lenses are also covered with no copay, while eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other services include oral exams, dental x-rays, and other diagnostic and preventive services with no copay, while restorative services and orthodontics have a $0 copay and a coinsurance between 0% and 50%, and implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Insulin has a $35 copay and 0-20% coinsurance for Medicare Part B Insulin Drugs. Other Medicare Part B drugs, and Medicare Part B Chemotherapy/Radiation Drugs, have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care OH-18 (HMO-POS C-SNP) plan, but require prior authorization. You are responsible for 20% coinsurance.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies, with 20% coinsurance for covered devices and supplies; Diabetic Equipment is covered with a copay for some supplies, and 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
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $50 copay, and lab services with no copay. Radiological Services include coverage for diagnostic radiological services with a copay of at most $130, therapeutic radiological services with a coinsurance of at least 20%, and outpatient X-ray services with a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care OH-18 (HMO-POS C-SNP) plan with no copay and no coinsurance, though additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not the Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required, and copays apply.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Complete Care OH-18 (HMO-POS C-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100.
Other Services See details
The UHC Complete Care OH-18 (HMO-POS C-SNP) plan covers Over-the-Counter (OTC) items and meal benefits with no copay, but 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. Meal benefits require prior authorization.
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