UHC Dual Complete HI-S001 (PPO D-SNP)

UHC Dual Complete HI-S001 (PPO D-SNP) is a PPO D-SNP plan offered by Unitedhealthcare Insurance Company available for the 2026 plan year to people living in State of Hawaii. CMS star rating not available for 2026.

It's important to know that UHC Dual Complete HI-S001 (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about UHC Dual Complete HI-S001 (PPO 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.

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:

Drug Coverage

The UHC Dual Complete HI-S001 (PPO D-SNP) Medicare plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are covered with no copay for a 1-month or 3-month supply at standard pharmacies and standard mail order. This provides an affordable option for individuals relying on common generic medications. For higher-tier medications, the plan transitions to a coinsurance model during the initial coverage phase. Tier 2 generic drugs, Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all carry a 25% coinsurance for standard pharmacy and standard mail order options. This consistent percentage allows you to easily project your out-of-pocket costs for brand-name and specialty prescriptions.

Additional Benefits

The UHC Dual Complete HI-S001 (PPO D-SNP) plan offers robust health coverage with many essential services requiring no copay. Beneficiaries enjoy no copay for primary care, specialist visits, home health, and preventive care, with coinsurance ranging from 0% to 20%. Dental services are covered up to a $2,000 annual limit with no copay, while diagnostic hearing and vision services also feature no copays or coinsurance. For emergency and hospital care, the plan features a $115 emergency room copay, which is waived if admitted, and a $2,030 copay per inpatient hospital stay. Outpatient procedures, dialysis, and durable medical equipment are covered with no copay and a 20% coinsurance. Additionally, members can access up to 24 one-way transportation trips and select over-the-counter items with no copay and no coinsurance.

Plan Providers

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, HealthSpring^SM, 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.