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UHC Complete Care WI-20 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care WI-20 (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 WI-20 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care WI-20 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in Select Counties in Wisconsin. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UHC Complete Care WI-20 (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 WI-20 (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 WI-20 (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 WI-20 (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 $520.00 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 $5400.00 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:
Sign up for UHC Complete Care WI-20 (HMO-POS C-SNP)
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Drug Coverage
The UHC Complete Care WI-20 (HMO-POS C-SNP) prescription drug plan features an annual drug deductible of $520. For Tier 1 preferred generic drugs, members pay no copay for standard pharmacy fills and mail-order services. Tier 2 generic drugs require a $10 copay for a 1-month supply at standard pharmacies, though you can get a 3-month supply with no copay through preferred mail order. For Tier 3 preferred brand drugs, members pay an 18% coinsurance across standard pharmacy and mail-order options. Tier 4 non-preferred drugs require a 42% coinsurance, while Tier 5 specialty drugs carry a 27% coinsurance. These coinsurance rates apply to 1-month supplies filled at standard pharmacies and through mail order.
Additional Benefits
The UHC Complete Care WI-20 (HMO-POS C-SNP) plan offers comprehensive coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. Specialist visits, outpatient services, and emergency care are covered with no coinsurance, though they require varying copays such as a $130 copay for emergency room visits. Inpatient hospital stays require a $495 daily copay for the first few days, after which there is no copay for the remainder of your stay. For additional wellness needs, this plan provides routine vision and hearing exams with no copay, alongside allowances for eyewear and copays for prescription hearing aids. Preventive dental care, home health services, and diabetic supplies are fully covered with no copay or coinsurance, while durable medical equipment and dialysis require a 20% coinsurance. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute hospital stays require a $495 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $495 daily copay for days 1-4 and no copay for days 5-90.
Outpatient Services See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $495 copay for outpatient hospital services and a $495 daily copay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions have no coinsurance and copays ranging from $0 to $25.
Partial Hospitalization See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers partial hospitalization services 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 WI-20 (HMO-POS C-SNP) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by UHC Complete Care WI-20 (HMO-POS C-SNP) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers primary care, telehealth, and opioid treatment with no copay and no coinsurance, while chiropractic services are not covered. Specialist visits, therapies, mental health, psychiatric, and podiatry services are covered with no coinsurance and copays ranging from $0 to $45.
Preventive Services See details
Preventive services are covered by UHC Complete Care WI-20 (HMO-POS C-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, glaucoma screenings, diabetes training, and cardiac/rectal exams. Additional preventive benefits are partially covered with no copay or coinsurance for fitness programs and home safety devices, though services such as health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by UHC Complete Care WI-20 (HMO-POS C-SNP) with no deductible and no coinsurance. Routine exams have no copay, but fitting and evaluation services are not covered. Up to two prescription hearing aids (copay of $199 to $1,249; inner, outer, and over-the-ear models not covered) and two OTC hearing aids (copay of $199 to $829) are covered annually.
Vision Services See details
Vision Services under the UHC Complete Care WI-20 (HMO-POS C-SNP) are partially covered, offering one routine eye exam per year with no deductible, copay, or coinsurance. Eyewear is covered with no deductible or coinsurance up to a $200 limit every two years, featuring no copay for contact lenses and frames, and a $0 to $153 copay for lenses, while upgrades, other eye exams, and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by UHC Complete Care WI-20 (HMO-POS C-SNP), with preventive care offered at no copay and no coinsurance, and Medicare-covered dental services requiring no copay and 20% coinsurance. Restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, orthodontics, adjunctive general services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin drugs have a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under UHC Complete Care WI-20 (HMO-POS C-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care WI-20 (HMO-POS C-SNP), offering durable medical equipment and prosthetics with no copay and a 20% coinsurance. Diabetic supplies and therapeutic shoes are covered with no copay and no coinsurance, though manufacturer limitations apply and prior authorization is required.
Diagnostic and Radiological Services See details
UHC Complete Care WI-20 (HMO-POS C-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests require a $50 copay with no coinsurance, outpatient X-rays have a $25 copay, and therapeutic radiology has a 20% coinsurance, while lab and diagnostic radiological services are covered with no copay.
Home Health Services See details
Home Health Services are covered under the UHC Complete Care WI-20 (HMO-POS C-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by UHC Complete Care WI-20 (HMO-POS C-SNP) with no copay, no coinsurance, and a prior authorization requirement, though only some services are covered. Specifically, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
UHC Complete Care WI-20 (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, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC Complete Care WI-20 (HMO-POS C-SNP), including meal benefits for chronic illnesses and over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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