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UHC Dual Complete KY-V001 (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete KY-V001 (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 KY-V001 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete KY-V001 (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 State of Kentucky. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Complete KY-V001 (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 KY-V001 (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 KY-V001 (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 KY-V001 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.50. 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 $6700.00 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 KY-V001 (HMO-POS D-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic medications, members benefit from no copay for 1-month and 3-month supplies at standard pharmacies and standard mail order. This makes starting and maintaining basic prescriptions highly affordable. For higher-tier medications, the plan requires a consistent 25% coinsurance. This 25% coinsurance applies to Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs filled at standard pharmacies or through standard mail order. Understanding these cost-sharing tiers helps you accurately budget for your monthly prescription needs.
Additional Benefits
The UHC Dual Complete KY-V001 (HMO-POS D-SNP) plan offers comprehensive coverage that minimizes out-of-pocket expenses for essential medical care. Members benefit from no copays and no coinsurance for primary care visits, telehealth services, routine preventive care, and home health services. Specialist visits feature low copays ranging from no copay up to $30, while emergency room visits require a $130 copay that is waived upon hospital admission. For hospital stays, inpatient services require a $455 daily copay for the first few days followed by no copay, and outpatient hospital services range from no copay up to a $455 copay. Additionally, the plan provides valuable extra benefits including routine dental, vision, and hearing exams with no copays, alongside up to 24 free one-way transportation trips per year. Select services like durable medical equipment and dialysis require a 20% coinsurance with no copay.
Inpatient Hospital See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $455 copay per day for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, followed by no copay for remaining covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital and observation services have copays ranging from $0 to $455, while outpatient substance abuse sessions have copays between $0 and $25.
Partial Hospitalization See details
Partial hospitalization is covered under the UHC Dual Complete KY-V001 (HMO-POS D-SNP) plan with a $55.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers ground and air ambulance services with a $290 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved locations via taxi or medical transport with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers emergency services 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 ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance.
Primary Care See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers primary care and telehealth services with no copay and no coinsurance. Specialist visits have a $0 to $30 copay, physical, occupational, and speech therapies require a $25 copay, and routine chiropractic care is not covered, all with no coinsurance.
Preventive Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and caregiver support. This benefit is partially covered, as health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, tobacco cessation, disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) offers partially covered hearing services, featuring routine hearing exams with no copay and no coinsurance, though fitting and evaluation exams are not covered. Prescription hearing aids (copays of $199 to $1,249) and OTC hearing aids (copays of $199 to $829) are covered with no coinsurance for up to two devices per year, but inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) provides partially covered vision services with no copay and no coinsurance, featuring one routine eye exam per year and a $200 annual maximum for contact lenses, eyeglass lenses, and frames. Other eye exam services, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete KY-V001 (HMO-POS D-SNP), excluding implant services and orthodontics. Preventive care has no copay and no coinsurance up to a $1,000 annual limit, while Medicare-covered services require a 20% coinsurance and comprehensive services require a 50% coinsurance, both with no copays.
Home Infusion bundled Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and between no coinsurance and 20% coinsurance, while insulin requires a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete KY-V001 (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers medical equipment, featuring no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Covered diabetic supplies have no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic tests for a $40 copay. Covered radiological services require prior authorization and include diagnostic radiology with no copay, outpatient X-rays for a $25 copay, and therapeutic radiology with a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete KY-V001 (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) features no coinsurance for cardiac rehabilitation services, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete KY-V001 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Other Services are partially covered by the UHC Dual Complete KY-V001 (HMO-POS D-SNP) plan, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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