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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 2025, 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 4 out of 5 stars in 2025.
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 $39.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.10. 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 $590.00 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 $9350.00 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) plan has a $590 deductible for prescription drugs. Once you meet your deductible, you will pay the costs for your drugs according to the plan's formulary until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for covered Part D drugs. This plan's premium may be reduced if you qualify for the low-income subsidy, with a monthly premium of $39.30.
Additional Benefits
The UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing structures. Inpatient hospital stays have a high copay, while outpatient services and primary care have coinsurance between 0% and 20%. Emergency services have a copay, but other services such as preventive services, hearing, vision, dental, and home health services are often available with no copay. The plan includes coverage for home infusion, dialysis, and medical equipment with coinsurance requirements. Additional benefits include transportation services and other services, such as OTC items and meal benefits, with no copay. However, some services like cardiac rehabilitation and skilled nursing facility services are not covered.
Inpatient Hospital See details
The UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan covers inpatient hospital stays with a copay of $1790 per admission or stay, and additional days for inpatient hospital-acute with no copay for days 91-999; however, non-Medicare-covered stays and upgrades for inpatient hospital-acute, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including all outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a coinsurance of 0% - 20%, observation services have a 20% coinsurance, and individual sessions for outpatient substance abuse have a 0% - 20% coinsurance, while group sessions have a 20% coinsurance; outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
The UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan covers ambulance services with a 20% coinsurance for ground and air ambulance services, and transportation services with no copay. Transportation services to any health-related location are not covered, however, the plan does cover 48 one-way trips per year to plan-approved health-related locations via taxi or medical transport.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a copay between $0 and $45; all three have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Primary Care Physician Services, Physician Specialist Services, Physical Therapy, and Speech-Language Pathology Services have a coinsurance of 0% to 20%, while Chiropractic Services have a 20% coinsurance. Mental Health Specialty Services and Psychiatric Services have a coinsurance of 0% to 20% for individual sessions, and a 20% coinsurance for group sessions. Podiatry Services have a 20% coinsurance for routine foot care, and no copay, and Additional Telehealth Benefits and Opioid Treatment Program Services have no copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and additional preventive services, including fitness benefits, with no copay, and home and bathroom safety devices with no copay. Glaucoma screenings, diabetes self-management training, and barium enemas are covered with no copay, while digital rectal exams and EKG following the welcome visit have 20% coinsurance. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
The UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan covers hearing exams with a coinsurance of at most 20% for routine hearing exams, and prescription hearing aids with a maximum benefit of $1500 per year. OTC hearing aids are covered with no copay.
Vision Services See details
Vision services include eye exams, routine eye exams, eyewear, contact lenses, eyeglass lenses, and eyeglass frames. Routine eye exams, contact lenses, eyeglass lenses, and eyeglass frames have no copay, while eyeglass lenses and frames are limited to one per year, and contact lenses are unlimited. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other Dental Services include oral exams, dental x-rays, and other diagnostic and preventive services with no copay. Restorative services, orthodontics, and other services are covered with a copay of $0, but some services require prior authorization. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while the other drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the UHC Dual Complete OH-D002 (HMO-POS D-SNP) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not provide Skilled Nursing Facility Services as a supplemental benefit under Part C. The plan does not cover additional days beyond Medicare-covered for SNF, or non-Medicare-covered stays for SNF.
Other Services See details
Other services covered by the UHC Dual Complete OH-D002 (HMO-POS D-SNP) include Over-the-Counter (OTC) Items and Meal Benefits. Over-the-Counter (OTC) Items have no copay, and Meal Benefits also have no copay, but require prior authorization. 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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