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UHC Complete Care VA-21 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care VA-21 (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 VA-21 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care VA-21 (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 Virginia. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Complete Care VA-21 (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 VA-21 (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 VA-21 (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 VA-21 (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 $440.00 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 $5900.00 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 VA-21 (HMO-POS C-SNP) plan features an annual prescription drug deductible of $440. For Tier 1 preferred generic drugs, you will pay no copay for 1-month or 3-month supplies at standard pharmacies, as well as 3-month mail-order prescriptions. Tier 2 generic drugs cost a $14 copay for a 1-month standard pharmacy supply and a $42 copay for a 3-month supply, though you can get a 3-month supply with no copay through preferred mail order. For higher-tier medications, costs are based on coinsurance percentages during the initial coverage phase. Tier 3 preferred brand drugs require an 18% coinsurance for both 1-month and 3-month supplies across standard pharmacies and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 41% coinsurance and a 28% coinsurance respectively for 1-month supplies across standard pharmacies and mail-order channels.
Additional Benefits
The UHC Complete Care VA-21 (HMO-POS C-SNP) offers robust healthcare coverage with no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For more intensive care, the plan features no coinsurance for hospital stays, requiring a $395 copay for the first several days of acute or psychiatric care, while emergency room visits carry a $130 copay that is waived if you are admitted. Outpatient services, specialist visits, and diagnostic lab tests are also highly accessible, carrying low to no copays and no coinsurance. Additionally, members benefit from routine dental, vision, and hearing exams with no copay and no coinsurance, alongside a $300 eyewear allowance every two years. The plan covers over-the-counter items and chronic illness meals with no copay, while hearing aids are available with predictable copays and no coinsurance. Durable medical equipment, dialysis, and Medicare-covered dental services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by UHC Complete Care VA-21 (HMO-POS C-SNP) with no coinsurance, requiring a $395 copay for days 1 through 6 of acute care (with no copay for days 7 and beyond) and a $395 copay for days 1 through 5 of psychiatric care (with no copay for days 6 through 90). This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers outpatient hospital services with no coinsurance and copays ranging from no copay up to $395, depending on the service. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance. Outpatient substance abuse services also feature no coinsurance, with copays ranging from no copay up to $25 per session.
Partial Hospitalization See details
Partial hospitalization is covered by UHC Complete Care VA-21 (HMO-POS C-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance, subject to prior authorization. Transportation services are not covered, including transport to plan-approved or any other health-related locations.
Emergency Services See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care VA-21 (HMO-POS C-SNP) provides primary care physician visits and telehealth services with no copay and no coinsurance. Specialist visits, therapies, and mental health services have copays ranging from $0 to $40 and no coinsurance, though chiropractic services are only partially covered as routine chiropractic care is not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Complete Care VA-21 (HMO-POS C-SNP) with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, fitness benefits, and home safety devices. However, sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
UHC Complete Care VA-21 (HMO-POS C-SNP) provides partially covered hearing services, featuring one annual routine hearing exam with no copay, no deductible, and no coinsurance. While fitting and evaluation, along with inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, the plan covers up to two OTC hearing aids per year with a $199.00 to $829.00 copay and up to two other prescription hearing aids per year with a $199.00 to $1,249.00 copay, both with no coinsurance.
Vision Services See details
Vision Services are partially covered by UHC Complete Care VA-21 (HMO-POS C-SNP), offering one annual routine eye exam with no copay and no coinsurance, though prior authorization is required and other eye exams are not covered. Eyewear benefits feature no coinsurance and a $300 limit every two years, with no copay for contact lenses and frames, and a $0 to $153 copay for lenses, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental Services are partially covered by UHC Complete Care VA-21 (HMO-POS C-SNP), offering Medicare-covered dental care with no copay and a 20% coinsurance, alongside preventive services like cleanings, exams, and X-rays with no copay and no coinsurance. However, orthodontic, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and adjunctive general services are not covered under this plan.
Home Infusion bundled Services See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under UHC Complete Care VA-21 (HMO-POS C-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers durable medical equipment and prosthetics with no copay and 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes are also covered with no copay and no coinsurance, though limitations on manufacturers may apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care VA-21 (HMO-POS C-SNP) with no copay or coinsurance for lab services and diagnostic radiology. Diagnostic procedures and tests require a $30 copay with no coinsurance, outpatient X-rays have a $25 copay, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Complete Care VA-21 (HMO-POS C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no coinsurance under the UHC Complete Care VA-21 (HMO-POS C-SNP) plan, but in practice, the benefit is not covered because cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered.
Skilled Nursing Facility (SNF) See details
UHC Complete Care VA-21 (HMO-POS C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond Medicare coverage are not covered.
Other Services See details
Other services are partially covered by UHC Complete Care VA-21 (HMO-POS C-SNP), which offers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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