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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 $4900.00 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 has a deductible of $255. During the initial coverage phase, after you meet your deductible, you will pay a $0 copay for Standard Generic drugs, $47 copay, and $100 copay for Preferred Brand drugs. Non-Preferred drugs have 30% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), you will have no copay for Part D drugs.
Additional Benefits
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan offers comprehensive coverage with a variety of benefits, including inpatient and outpatient hospital care, with varying copays depending on the service. The plan includes coverage for primary care, preventive services, hearing, vision, and dental services, with specific copays and coinsurance amounts for each. Emergency, ambulance, and skilled nursing services are also covered, along with other services like home health and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $275 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For Inpatient Hospital Psychiatric, you also pay a $275 copay for days 1-5, and no copay for days 6-90, with no coinsurance.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $275, observation services have a $275 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
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 by the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan, with a $150 copay for both ground and air ambulance services and 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 under the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan. Emergency Services have a $125 copay, and no coinsurance. Urgently Needed Services have a copay between $0 and $55, with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay, and no coinsurance.
Primary Care See details
The UHC Complete Care TC-0005 (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 $10, and physician specialist services with a copay between $0 and $10. The plan also covers mental health specialty services, podiatry services with a $10 copay, other health care professional services with a copay between $0 and $10, psychiatric services, 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 annual physical exams with no copay. Additional preventive services, including Fitness Benefit and Home and Bathroom Safety Devices and Modifications, are covered with no copay. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), and others.
Hearing Services See details
Hearing services include hearing exams, prescription hearing aids, and OTC hearing aids. Hearing exams have no copay, while routine hearing exams are limited to one per year. Prescription hearing aids have a copay between $199 and $1249, with a limit of two per year, but fitting/evaluation for hearing aids, inner ear hearing aids, outer ear hearing aids, and over the ear hearing aids are not covered. OTC hearing aids have a copay between $99 and $829, with a limit of two per year.
Vision Services See details
The UHC Complete Care TC-0005 (HMO-POS C-SNP) plan covers vision services, including eye exams with no copay, and eyewear with no copay for contact lenses, and eyeglass frames. Eyeglass lenses have a copay of $0-$153, and the plan does not cover eyeglasses (lenses and frames) or upgrades.
Dental Services See details
Dental Services are covered, with a $2,500 annual maximum. Medicare Dental Services have a 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services have no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, Oral and Maxillofacial Surgery have no copay. Prosthodontics, removable, and Prosthodontics, fixed have a coinsurance of 0% - 50%. Implants and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and the coinsurance is between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Complete Care TC-0005 (HMO-POS C-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Diabetic supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a $50 copay, lab services with no copay, diagnostic radiological services with a copay up to $200, therapeutic radiological services with 20% coinsurance, 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 UHC Complete Care TC-0005 (HMO-POS C-SNP) 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 specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. 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. You will have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefit, with no copay for either. 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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