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UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Miami-Dade and Broward Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that UHC MedicareMax Dual Complete FL-D4 (HMO 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 MedicareMax Dual Complete FL-D4 (HMO 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 MedicareMax Dual Complete FL-D4 (HMO 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 MedicareMax Dual Complete FL-D4 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 $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:
Sign up for UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP)
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Drug Coverage
The UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for one-month and three-month supplies at standard pharmacies as well as three-month mail orders. This makes managing basic prescriptions highly cost-effective for members. For other drug categories, including Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members pay a 25% coinsurance. This 25% coinsurance applies to standard pharmacy fills and standard mail order options. Understanding these cost-sharing details helps you budget accurately for your medication needs with this HMO D-SNP plan.
Additional Benefits
The UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) plan provides comprehensive healthcare coverage with no copays for primary care, specialist consultations, and preventive services. For emergency services, members pay a $115 copay which is waived upon hospital admission, while inpatient hospital stays require a copayment of $2,230 for acute care and $2,080 for psychiatric care. Outpatient hospital services and surgeries are also highly accessible, featuring no copays and coinsurance ranging from 0% to 20%. Essential everyday benefits like routine dental care, annual vision exams with a $300 eyewear allowance, and hearing exams with a $2,200 hearing aid allowance are covered with no copays or coinsurance. Additionally, the plan offers skilled nursing facility care, home health services, and medical equipment at no cost to the member. Eligible individuals also benefit from unlimited one-way healthcare transportation and over-the-counter items with no copays or coinsurance.
Inpatient Hospital See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,230 copayment per stay for acute care and a $2,080 copayment per stay for psychiatric care. Prior authorization is required, and non-Medicare-covered stays, hospital upgrades, and psychiatric additional days are not covered.
Outpatient Services See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) covers outpatient services with no copays, though a coinsurance of 0% to 20% applies to outpatient hospital, observation, and ambulatory surgical center services. Outpatient substance abuse and blood services are covered with no copays and no coinsurance, with prior authorization required for most outpatient care.
Partial Hospitalization See details
Partial hospitalization is covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services through UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) are partially covered, with ground and air ambulance services requiring prior authorization and a 20% coinsurance with no copay. Unlimited one-way transportation to plan-approved health-related locations is covered with no copay and no coinsurance, but transportation to any health-related location is not covered.
Emergency Services See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services and worldwide emergency, urgent, and transportation services are also covered with no copays and no coinsurance.
Primary Care See details
Primary care benefits under UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) feature no copay and 0% to 20% coinsurance for primary care provider visits, while specialist, mental health, psychiatric, and telehealth services have no copay and no coinsurance. Physical, occupational, and speech therapies require no copay and a 20% coinsurance, routine podiatry is limited to 6 visits per year with a 20% coinsurance, and chiropractic services are not covered.
Preventive Services See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for covered benefits like annual exams, kidney disease education, and fitness programs. Excluded from coverage are health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) offers partially covered hearing services with no copay and no coinsurance, which includes one annual routine exam and up to two prescription or OTC hearing aids every two years with a $2,200 allowance. Fitting and evaluation for hearing aids, alongside inner ear, outer ear, and over the ear prescription hearing aids, are not covered under this plan.
Vision Services See details
Vision Services are partially covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP), featuring no copay, no coinsurance, and no deductible for covered options like one routine eye exam per year and contact lenses or eyeglasses up to a $300 annual limit. Other eye exam services, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental Services are partially covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) with no copay and no coinsurance for covered benefits, including oral exams, cleanings, x-rays, fluoride, restorative care, removable prosthodontics, and oral surgery. Non-covered services under this plan include other diagnostic and preventive services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) with no coinsurance, and there are no copays or coinsurance for covered Medicare Part B drugs like insulin and chemotherapy. Prior authorization is required for these services, and step therapy may apply.
Dialysis Services See details
Dialysis Services are covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Medical Equipment See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and no coinsurance. Prior authorization is required for these benefits, and coverage may be limited to preferred vendors and specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) with prior authorization. Lab services have no copay, diagnostic radiological services have no copay and no coinsurance, and diagnostic procedures require a copay and 20% coinsurance. Therapeutic radiological services and outpatient X-rays are covered with no copay and a 20% coinsurance.
Home Health Services See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) plan, but in practice, some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered. For these non-covered services, there is no copay and no coinsurance.
Skilled Nursing Facility (SNF) See details
UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP) covers skilled nursing facility (SNF) care for days 1 through 100 with no copay and no coinsurance, and does not require a prior three-day inpatient hospital stay. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by UHC MedicareMax Dual Complete FL-D4 (HMO D-SNP), featuring no copay and no coinsurance for covered benefits like over-the-counter (OTC) items and chronic illness meal benefits. Acupuncture and other additional services are not covered under this plan, and the meal benefit requires prior authorization.
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