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UHC Dual Complete KY-S002 (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-S002 (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-S002 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete KY-S002 (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-S002 (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-S002 (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-S002 (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-S002 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.10. 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:
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Drug Coverage
The UHC Dual Complete KY-S002 (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for one-month and three-month supplies at standard pharmacies. Additionally, there is no copay for a three-month supply of these preferred generic medications filled through standard mail order. For Tier 2 generic, Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% coinsurance applies to both standard pharmacy fills and standard mail order options. This consistent coinsurance rate helps you easily calculate your out-of-pocket costs for brand-name and specialty medications.
Additional Benefits
The UHC Dual Complete KY-S002 (HMO-POS D-SNP) plan offers robust healthcare coverage with no copay for primary care visits, specialist consultations, and outpatient hospital services, though some treatments may require up to 20% coinsurance. Inpatient hospital stays carry an $1,800 copay per stay with no coinsurance, whereas emergency room visits require a $115 copay that is waived upon admission. Routine preventive services, home health care, and skilled nursing facility stays are fully covered with no copay and no coinsurance. For extra wellness support, the plan provides dental and vision benefits with no copay, including a $1,500 annual dental allowance and a $200 eyewear allowance. Members also benefit from no copay for over-the-counter items, routine hearing exams, and up to 24 one-way transportation trips per year to plan-approved locations. Other essential services, such as durable medical equipment and dialysis, are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP) with an $1,800 copay per stay and no coinsurance for Medicare-covered acute and psychiatric stays. While unlimited additional acute hospital days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers outpatient services, including hospital, ambulatory surgical center, substance abuse, and blood services, with no copays. Prior authorization is required for these services, with coinsurance ranging from no coinsurance to 20% depending on the specific care received.
Partial Hospitalization See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation benefits are partially covered, offering up to 24 one-way trips per year to plan-approved locations via taxi or medical transport with no copay or coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP) with a $115 copay—which is waived if admitted to the hospital within 24 hours—and no coinsurance. Urgently needed services require a copay of $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are offered with no copays and no coinsurance.
Primary Care See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers primary care and specialist visits with no copay and 0% to 20% coinsurance, while telehealth and opioid treatment services are offered with no copay and no coinsurance. Other professional services like physical and occupational therapies require no copay and 20% coinsurance, though chiropractic services are not covered in practice.
Preventive Services See details
Preventive services are covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP) with no copay and no coinsurance for most services, including annual physicals, diabetes training, and fitness benefits, while digital rectal exams and EKGs require a 20% coinsurance. Additional preventive services are partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP), offering one annual routine hearing exam with no copay and 20% coinsurance, while fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no copay and no coinsurance up to two devices every two years (with a $1,500 limit for prescription aids), though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP) with no copay and no coinsurance for covered services, which include one routine eye exam and a $200 annual allowance for eyewear. Other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered under this plan.
Dental Services See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) partially covers dental services, offering up to $1,500 in annual coverage with no copay and no coinsurance for preventive and most comprehensive care, though implant services and orthodontics are not covered. Medicare-covered dental services are available with no copay and a 20% coinsurance.
Home Infusion bundled Services See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by UHC Dual Complete KY-S002 (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-S002 (HMO-POS D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with no copays and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under UHC Dual Complete KY-S002 (HMO-POS D-SNP) with prior authorization required. Diagnostic radiological services have no copay and no coinsurance, lab services have no copay, and diagnostic tests, therapeutic radiology, and outpatient X-rays require a minimum 20% coinsurance with copays only applying to diagnostic tests.
Home Health Services See details
Home health services are covered by UHC Dual Complete KY-S002 (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under UHC Dual Complete KY-S002 (HMO-POS D-SNP) feature no copay, meaning some services are covered, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services 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 Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete KY-S002 (HMO-POS D-SNP) partially covers other services, offering over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires prior authorization.
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