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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
UHC Dual Complete OH-D002 (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Care Improvement Plus South Central Insurance Co. available for the 2026 plan year 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.
Below are a few key facts and commonly-asked questions about UHC Dual Complete OH-D002 (HMO-POS D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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.
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 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.
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.
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 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.
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.
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 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 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.
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 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 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 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.
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.
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.
UHC Dual Complete OH-D002 (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
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.
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 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.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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