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UHC Dual Choice DC-Y001 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Choice DC-Y001 (HMO 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 Choice DC-Y001 (HMO D-SNP) in 2026, please refer to our full plan details page.
UHC Dual Choice DC-Y001 (HMO D-SNP) is a HMO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Washington, DC. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that UHC Dual Choice DC-Y001 (HMO 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 Choice DC-Y001 (HMO 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 Choice DC-Y001 (HMO 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 Choice DC-Y001 (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $13.40. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $0.20. 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 $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 Choice DC-Y001 (HMO D-SNP) prescription drug coverage includes an annual drug deductible of $615. Beneficiaries must pay this deductible amount out-of-pocket for covered medications before the plan's drug coverage begins to pay. This deductible is a key factor to consider when calculating your total yearly healthcare expenses. Detailed information regarding drug coverage tiers, copays, and coinsurance is not available for this plan. To determine how your specific medications are covered, you should consult the plan's formulary or contact the provider directly. This will help you understand your potential out-of-pocket costs for prescription drugs under this plan.
Additional Benefits
The UHC Dual Choice DC-Y001 (HMO D-SNP) offers essential medical coverage with no copays for primary care, specialist visits, and outpatient services, though coinsurance ranges from 0% to 20% for these services. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care, both featuring no coinsurance. Emergency care is available with a $115 copay, which is waived upon admission, while urgently needed services carry a copay between no copay and $40. For specialized care, the plan covers home health services and diabetic supplies with no copay and no coinsurance, while durable medical equipment and Medicare-covered dental services require a 20% coinsurance with no copay. Routine vision benefits and hearing aids are not covered, but members do receive one routine hearing exam per year with no copay and 20% coinsurance. Additionally, the plan offers over-the-counter items and meal benefits for chronic illnesses with no copay or coinsurance.
Inpatient Hospital See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers outpatient services, including hospital, ambulatory surgical center, substance abuse, and blood services, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by UHC Dual Choice DC-Y001 (HMO D-SNP), offering ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. However, transportation services to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the UHC Dual Choice DC-Y001 (HMO D-SNP) plan with a $115 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services require a copay of $0 to $40 and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance.
Primary Care See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers primary care, specialist, and mental health services with no copays and 0% to 20% coinsurance, while telehealth and opioid treatments have no copays and no coinsurance. Physical, occupational, and speech therapies require a 20% coinsurance with no copay, whereas chiropractic services are not covered in practice.
Preventive Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) partially covers preventive services, offering annual physicals, kidney disease education, and fitness benefits with no copay and no coinsurance, while digital rectal exams and EKGs require a 20% coinsurance. Multiple services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, alternative therapies, and therapeutic massage.
Hearing Services See details
Hearing services are partially covered by UHC Dual Choice DC-Y001 (HMO D-SNP), which offers one routine hearing exam every year with no copay, 20% coinsurance, and no deductible, subject to prior authorization. While some prescription hearing aid services are covered, in practice all types—including inner ear, outer ear, and over the ear prescription hearing aids—as well as fitting evaluations and OTC hearing aids, are not covered.
Vision Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) technically offers vision services with no copay and no coinsurance, but the benefit is not covered in practice as routine eye exams, contact lenses, and eyeglasses are all not covered.
Dental Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) partially covers dental services, offering Medicare-covered dental services with no copay and a 20% coinsurance, with prior authorization required. Routine and comprehensive dental services, including oral exams, cleanings, x-rays, fluoride, restorative, and orthodontic services, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by UHC Dual Choice DC-Y001 (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin drugs also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Choice DC-Y001 (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Dual Choice DC-Y001 (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures require a copay and 20% coinsurance, lab services have no copay, and radiological services require no copay, featuring no coinsurance for diagnostic radiology and a 20% coinsurance for therapeutic radiology and X-rays.
Home Health Services See details
UHC Dual Choice DC-Y001 (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by UHC Dual Choice DC-Y001 (HMO D-SNP) with no copay and require prior authorization, although only some services are covered in practice. Specifically, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
UHC Dual Choice DC-Y001 (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services, as additional days beyond the Medicare-covered limit are not covered. Covered SNF stays require prior authorization, feature no coinsurance alongside Medicare-defined copayments, and do not require a 3-day prior inpatient hospital stay.
Other Services See details
Other services are partially covered by UHC Dual Choice DC-Y001 (HMO D-SNP), which offers over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Acupuncture is not covered under this plan, and prior authorization is required for the meal benefit.
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