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UHC Dual Complete FL-D005 (Regional PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Dual Complete FL-D005 (Regional 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 FL-D005 (Regional PPO D-SNP) in 2025, please refer to our full plan details page.
UHC Dual Complete FL-D005 (Regional PPO D-SNP) is a Regional PPO D-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in State of Florida. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that UHC Dual Complete FL-D005 (Regional 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 FL-D005 (Regional 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 FL-D005 (Regional 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 FL-D005 (Regional PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.20. 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 $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 combined Maximum Out-Of-Pocket cost of $14000.00 (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 $14000.00 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 FL-D005 (Regional PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2,000. If you qualify for the low-income subsidy (LIS), your monthly premium is $20.30. Once your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for covered drugs.
Additional Benefits
The UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan offers comprehensive coverage, including inpatient and outpatient services with varying copays and coinsurance amounts. This plan provides additional benefits such as no copay for primary care, preventive services, hearing exams, vision exams and eyewear, and dental services, as well as coverage for ambulance and transportation services. You will also find coverage for home health services and medical equipment, with coinsurance amounts applied to some services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, there is a $1,365 copay per admission or stay, and additional days (91-999) have no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered, and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, Outpatient Substance Abuse Services, and Outpatient Blood Services, are covered. Outpatient Hospital Services have a coinsurance of 0% to 20%, Observation Services have a 20% coinsurance, Individual Sessions for Outpatient Substance Abuse have a 0% to 20% coinsurance, Group Sessions for Outpatient Substance Abuse have a 20% coinsurance, and Outpatient Blood Services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a 20% coinsurance, and transportation services with no copay. The plan covers 36 one-way trips per year to a plan-approved health-related location via taxi or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, while Urgently Needed Services have a copay between $0 and $45 and no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay and no coinsurance.
Primary Care See details
The UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan covers primary care physician services with a coinsurance of 0% to 20%. Chiropractic services, including routine care, have no copay, and occupational therapy services have a coinsurance of 0% to 20%. Physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services and opioid treatment program services are covered, with varying coinsurance or copay amounts. Additional telehealth benefits are covered with no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while other services like glaucoma screenings, diabetes self-management training, and barium enemas have no copay, digital rectal exams and EKG following Welcome Visit have a 20% coinsurance. Additional preventive services such as health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, and others are not covered.
Hearing Services See details
Hearing Services includes hearing exams with no copay, and prescription hearing aids, with a maximum plan benefit of $2200 per year, and OTC hearing aids with no copay. Fitting/Evaluation for Hearing Aids, and Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered.
Vision Services See details
The UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and eyewear has a combined maximum benefit of $150 per year for both in-network and out-of-network services, with contact lenses and eyeglasses (lenses and frames) covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other 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 have no copay. Orthodontic and implant services are not covered, and orthodontic services are covered under Diagnostic and Preventive Dental.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs and other Medicare Part B drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan. This plan requires prior authorization and has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance; Diabetic Supplies have no copay and are subject to coinsurance, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services have no copay.
Home Health Services See details
Home Health Services are covered by the UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not cover additional days beyond Medicare-covered for SNF or non-Medicare-covered SNF stays. Prior authorization is required, and the plan charges the Medicare-defined cost share for tier 1, but other copay and coinsurance information is not available in the provided snippet.
Other Services See details
The UHC Dual Complete FL-D005 (Regional PPO D-SNP) plan covers Over-the-Counter (OTC) Items and Meal Benefits with no copay, but 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.
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