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UHC Dual Complete HI-Y1 (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete HI-Y1 (PPO 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 HI-Y1 (PPO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Complete HI-Y1 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2026 to people living in State of Hawaii. The overall rating for this plan is not yet available for 2026.
It's important to know that UHC Dual Complete HI-Y1 (PPO 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 HI-Y1 (PPO 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 HI-Y1 (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.
For UHC Dual Complete HI-Y1 (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $45.60. 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 combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 HI-Y1 (PPO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay for one-month or three-month supplies at standard pharmacies and standard mail order. This plan provides an affordable way to access essential medications with zero cost-sharing on the lowest tier. For Tier 2 generic and Tier 3 preferred brand drugs, the plan charges a 25% coinsurance for both standard pharmacy and standard mail order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply. Understanding these copay and coinsurance structures helps you estimate your out-of-pocket prescription expenses under this plan.
Additional Benefits
The UHC Dual Complete HI-Y1 (PPO D-SNP) offers comprehensive medical coverage, featuring a 1,935 dollar copay per stay for inpatient hospital admissions and no copay for outpatient services, though outpatient coinsurance ranges from 0% to 20%. Emergency care requires a 115 dollar copay, which is waived upon admission, while primary care visits generally feature no copay. Additionally, the plan covers home health and skilled nursing facility services with no copay and no coinsurance. For specialized care, dental services are covered up to a 2,500 dollar annual limit with no copay and no coinsurance for most preventive and comprehensive care. High-value extras include acupuncture and over-the-counter items with no copay or coinsurance, alongside up to 24 free one-way transportation trips per year. However, routine vision and hearing aid benefits are not covered under this plan.
Inpatient Hospital See details
UHC Dual Complete HI-Y1 (PPO D-SNP) partially covers inpatient hospital services, requiring a $1,935 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Prior authorization is required, and while unlimited additional acute days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers outpatient services with no copayments, though prior authorization is required. Depending on the specific service, coinsurance ranges from 0% to 20% for outpatient hospital, ambulatory surgical center, substance abuse, and blood services.
Partial Hospitalization See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered under UHC Dual Complete HI-Y1 (PPO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Complete HI-Y1 (PPO D-SNP) primary care benefits are partially covered, generally featuring no copay and coinsurance ranging from no coinsurance to 20% for doctor visits, mental health, and therapy services. While routine chiropractic and podiatry care are covered within specific visit limits, other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by UHC Dual Complete HI-Y1 (PPO D-SNP), offering annual exams, fitness benefits, and caregiver support with no copay and no coinsurance, while digital rectal exams and post-welcome visit EKGs require a 20% coinsurance and no copay. Sub-services not covered include 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 benefits, home-based palliative care, smoking cessation counseling, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by UHC Dual Complete HI-Y1 (PPO D-SNP), which provides covered hearing exams with no copay and no coinsurance, though prior authorization is required. Routine hearing exams, fitting and evaluation services, and all prescription and over-the-counter hearing aids are not covered under this plan.
Vision Services See details
Vision Services under UHC Dual Complete HI-Y1 (PPO D-SNP) feature no copay and no coinsurance, but because routine eye exams, contact lenses, and eyeglasses are not covered, this benefit is not covered in practice.
Dental Services See details
Dental services are partially covered by UHC Dual Complete HI-Y1 (PPO D-SNP) up to a $2,500 annual limit, with implant services and orthodontics not covered. Under this plan, Medicare-covered dental services have no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services require no copay and no coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Complete HI-Y1 (PPO D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Dual Complete HI-Y1 (PPO D-SNP) with prior authorization, featuring no copay for lab services and a copay plus 20% coinsurance for diagnostic procedures. Radiological services require no copays, offering diagnostic radiological services with no coinsurance, while therapeutic radiological and outpatient X-ray services require a 20% coinsurance.
Home Health Services See details
Home health services are covered by UHC Dual Complete HI-Y1 (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
UHC Dual Complete HI-Y1 (PPO D-SNP) covers some Cardiac Rehabilitation Services with no copay and 20% coinsurance, requiring prior authorization. However, specific services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by UHC Dual Complete HI-Y1 (PPO D-SNP) with no copay and no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. Additional days beyond the standard Medicare-covered limit are not covered under this plan.
Other Services See details
UHC Dual Complete HI-Y1 (PPO D-SNP) provides partial coverage for other services, offering acupuncture treatments (up to 20 per year) and over-the-counter items with no copay and no coinsurance. Meal benefits and other additional services are not covered under this benefit.
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