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UHC Complete Care TC-0005 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care TC-0005 (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 TC-0005 (HMO-POS C-SNP) in 2025, please refer to our full plan details page.
UHC Complete Care TC-0005 (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 Tennessee and Select Counties in Virginia. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Complete Care TC-0005 (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 TC-0005 (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 TC-0005 (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 TC-0005 (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 $255.00 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 TC-0005 (HMO-POS C-SNP) plan has an enhanced alternative drug benefit. The plan includes a $255 deductible. In the initial coverage phase, after the deductible is met, you will pay varying copays and coinsurance depending on the drug tier and pharmacy used. For example, standard generic drugs have a $47 copay, while preferred brand drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, and you pay nothing for covered drugs.
Additional Benefits
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan offers a wide range of benefits with varying cost-sharing. Many services have no copay, including primary care, preventive services, home health, and vision services like routine eye exams and contact lenses. However, some services have copays, such as inpatient hospital stays, outpatient services, and ambulance services. This plan also covers dental services up to a $1000 maximum benefit per year and provides coverage for hearing exams and some hearing aids. Additional benefits include coverage for diagnostic and radiological services, home infusion, and skilled nursing facility stays, each with its own cost structure, including coinsurance for certain services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $395 copay for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional days 91-999 for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and 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 between $0 and $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have a copay between $0 and $25 for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan. Both 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 TC-0005 (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $55. Worldwide Emergency Services has a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan offers primary care services with no copay, chiropractic services with a $20 copay, occupational therapy with a copay between $0 and $10, and physician specialist services with a copay between $0 and $10. This plan also covers mental health specialty services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, podiatry services with a $10 copay, other health care professional services with a copay between $0 and $10, psychiatric services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, physical therapy and speech-language pathology services with a copay between $0 and $10, additional telehealth benefits with no copay, and opioid treatment program services with no copay. Routine chiropractic care is not covered.
Preventive Services See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan covers preventive services including an annual physical exam with no copay, and additional preventive services with no copay for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. The plan does not cover Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and other services.
Hearing Services See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan covers hearing exams with no copay, routine hearing exams with no copay, and OTC hearing aids with a copay between $99 and $829. Prescription hearing aids are partially covered, but fitting/evaluation for hearing aids, 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 TC-0005 (HMO-POS C-SNP) plan covers vision services, including routine eye exams and eyewear. Routine eye exams and contact lenses have no copay, while eyeglass lenses have a copay of $0-$153, and eyeglass frames have no copay.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with 20% coinsurance and other dental services up to a $1000 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay; however, the number of visits and periodicity vary. Restorative services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay, and the number of visits and periodicity vary. Prosthodontics, removable and fixed, have a coinsurance between 0% and 50%, while implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with 0% to 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment includes Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment with a copay for Medicare-covered diabetic supplies and therapeutic shoes/inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan covers Diagnostic and Radiological Services. Diagnostic Procedures/Tests have a $40 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $225, Therapeutic Radiological Services have a copay of at most $50, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care TC-0005 (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
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $203 copay; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits. There is no copay for OTC items and meals, and the plan does not cover 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, or Self-Directed Personal Assistance Services.
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