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UHC Dual Complete OH-D002 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete OH-D002 (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Dual Complete OH-D002 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete OH-D002 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in Ohio. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete OH-D002 (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Dual Complete OH-D002 (HMO-POS D-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 Dual Complete OH-D002 (HMO-POS D-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 Dual Complete OH-D002 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.90. You must continue to pay paying your reduced 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 $615.00 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 $9250.00 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 Dual Complete OH-D002 (HMO-POS D-SNP) prescription drug plan has an annual drug deductible of $615. Members enjoy no copay for Tier 1 preferred generic drugs filled at standard pharmacies or through standard mail order. This ensures that basic generic medications remain highly affordable. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance. This 25% coinsurance rate applies to standard pharmacy and standard mail order fills for both short-term and extended supplies where applicable.
Additional Benefits
The UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan offers robust medical coverage, featuring no copay for primary care visits, outpatient hospital services, and home health care. While inpatient hospital stays require a $1,980 copay, skilled nursing facility stays and annual preventive physicals are covered with no copay and no coinsurance. Emergency room visits carry a $115 copay, which is waived upon admission, while urgent care and worldwide emergency services are available with little to no copay. Additionally, this plan provides valuable supplemental benefits, including routine dental, vision, and hearing services with no copay and no coinsurance for routine exams, glasses, and select hearing aids. Members also enjoy no copay for up to 24 one-way transportation trips to approved locations and over-the-counter items. For specialized services like dialysis, physical therapy, and durable medical equipment, the plan features no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP) with a $1,980 copay per stay and no coinsurance for Medicare-covered acute and psychiatric stays, subject to prior authorization. Unlimited additional acute care days are covered with no copay, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers outpatient services with no copays, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Coinsurance for these covered services ranges from no coinsurance up to 20%, and prior authorization is required for most treatments.
Partial Hospitalization See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP), with ground and air ambulance services requiring a 20% coinsurance and no copay. Up to 24 one-way trips to plan-approved health-related locations are covered with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers primary care, specialist, and mental health services with no copay and 0% to 20% coinsurance, while telehealth and opioid treatments have no copay and no coinsurance. Physical, occupational, and speech therapies require no copay and 20% coinsurance, and although some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services under the UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan are partially covered, offering no copay and no coinsurance for annual physicals, kidney disease education, and fitness benefits. While certain services like digital rectal exams and post-welcome-visit EKGs require a 20% coinsurance, other supplemental benefits such as health education, nutritional counseling, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP) include one routine hearing exam annually with no copay and a 20% coinsurance, though fitting and evaluation services are not covered. Additionally, the plan covers up to two OTC hearing aids and some prescription hearing aid services every two years with no copay and no coinsurance, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) offers partially covered vision services with no copay and no coinsurance. Covered benefits include one routine eye exam per year (prior authorization required) and contact lenses or one pair of eyeglasses (lenses and frames) annually, while other eye exams, individual eyeglass lenses, and individual frames are not covered.
Dental Services See details
Dental Services are partially covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP), with Medicare-covered dental requiring no copay and a 20% coinsurance, and other preventive and comprehensive services offered with no copay and no coinsurance. Most dental services like cleanings, exams, and implants are covered, but fixed prosthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copays and a 20% coinsurance. Diabetic supplies feature no copay, while diabetic therapeutic shoes and inserts have a 20% coinsurance, with prior authorization required for most services.
Diagnostic and Radiological Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and diagnostic radiological services with no copay or coinsurance. Diagnostic procedures require a copay and a minimum 20% coinsurance, while outpatient X-rays and therapeutic radiology require a minimum 20% coinsurance and no copay.
Home Health Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers some Cardiac Rehabilitation Services with no copay and prior authorization, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered. This benefit does not require a prior three-day inpatient hospital stay before admission.
Other Services See details
Other services are partially covered by UHC Dual Complete OH-D002 (HMO-POS D-SNP), including over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered, and prior authorization is required for the meal benefit.
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