A non-government entity
UHC Dual Complete KY-S4 (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-S4 (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-S4 (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete KY-S4 (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 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete KY-S4 (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-S4 (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-S4 (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-S4 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.60. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.60. 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:
Sign up for UHC Dual Complete KY-S4 (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs. The plan's formulary will tell you the specific costs of each drug. If you qualify for the low-income subsidy, you will pay $49.60 per month. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, and you will pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays and coinsurance. The plan also covers primary care, preventive services, hearing, vision, dental, home health, and medical equipment. Additional benefits include ambulance and transportation services, emergency services, and home infusion services. The plan also covers OTC items and a meal benefit, while certain services like cardiac rehabilitation and private duty nursing are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered under the UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan. For Inpatient Hospital-Acute, you will pay a copay of $1655 per admission or stay, with no copay for additional days between days 91-999; Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. For Inpatient Hospital Psychiatric, you will pay a copay of $1655 per admission or stay; additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a coinsurance between 0% and 20%, observation services have a 20% coinsurance, and ambulatory surgical center services have a coinsurance between 0% and 20%. Individual sessions for outpatient substance abuse have a coinsurance between 0% and 20%, while group sessions have a 20% coinsurance. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the plan with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, while Transportation Services to a Plan Approved Health-related Location are covered with no copay for up to 60 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, Urgently Needed Services have a copay between $0 and $45, and Worldwide Emergency Services have varying copays depending on the service.
Primary Care See details
Primary Care benefits 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, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. The plan has a coinsurance of 0% to 20% for Primary Care Physician Services, 20% for Chiropractic Services, 0% to 20% for Occupational Therapy Services, 0% to 20% for Physician Specialist Services, 0% to 20% for Individual Sessions for Mental Health Specialty Services, 20% for Group Sessions for Mental Health Specialty Services, 20% for Routine Foot Care, 0% to 20% for Other Health Care Professional, 0% to 20% for Individual Sessions for Psychiatric Services, 20% for Group Sessions for Psychiatric Services, and 0% to 20% for Physical Therapy and Speech-Language Pathology Services. The plan has no copay for Additional Telehealth Benefits and Opioid Treatment Program Services. Routine Chiropractic Care is not covered.
Preventive Services See details
The UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan covers preventive services, including an annual physical exam with no copay. Other preventive services are covered, but Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, 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, and Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline) are not covered.
Hearing Services See details
Hearing services include routine hearing exams with no copay and a 20% coinsurance for routine hearing exams, and prescription hearing aids with no copay, with a plan maximum benefit of $2200 per year. OTC hearing aids are covered with no copay.
Vision Services See details
The UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan covers vision services, including eye exams with no copay, and eyewear with a combined maximum of $250 per year. Eyeglass lenses, eyeglass frames, and contact lenses are covered with no copay, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental services are covered, including Medicare Dental Services with 20% coinsurance. Other Dental Services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, and oral and maxillofacial surgery, all with no copay. However, implants and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered, but require Prior Authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, while Diabetic Supplies have no copay. Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, are covered with a coinsurance of up to 20%, while lab services have no copay. Therapeutic radiological services and outpatient X-ray services are covered with a coinsurance of up to 20%, and diagnostic radiological services have a coinsurance of up to 20% with a minimum of 0%.
Home Health Services See details
Home health services are covered under the UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan, but require prior authorization. The plan does not offer additional days beyond Medicare-covered for SNF, and does not cover non-Medicare-covered stays for SNF.
Other Services See details
The UHC Dual Complete KY-S4 (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) items with no copay, and a meal benefit with no copay, but requires 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved