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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 2026, 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 3.5 out of 5 stars in 2026.
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 $4.80. 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 FL-D005 (Regional PPO D-SNP) Medicare prescription drug coverage features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies, and no copay for a 3-month supply through standard mail order. This plan provides an affordable option for those relying primarily on preferred generic medications. For Tier 2 generic drugs, Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs, the cost-sharing is a consistent 25% coinsurance. This 25% coinsurance applies to both standard pharmacy and standard mail order fills, with specific supply limits depending on the medication tier. These straightforward coinsurance rates make it easy to estimate your out-of-pocket prescription costs.
Additional Benefits
The UHC Dual Complete FL-D005 (Regional PPO D-SNP) offers comprehensive healthcare coverage with no copays for primary care, preventive services, home health, and skilled nursing care. While many routine services require no copay, other medical needs like dialysis, outpatient services, and durable medical equipment are subject to a coinsurance of up to 20%. Inpatient hospital stays require a $1,860 copay per stay, while emergency room visits have a $115 copay that is waived if you are admitted. This plan also delivers valuable supplemental benefits, including routine vision and hearing exams with no copays or coinsurance. Members receive up to a $1,500 allowance for hearing aids every two years and an additional $1,500 annual limit for comprehensive dental care with no copay. Other covered perks include over-the-counter items and specialized meal benefits with no copay or coinsurance to support your daily well-being.
Inpatient Hospital See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers inpatient hospital services with a $1,860 copay per stay and no coinsurance, requiring prior authorization. This benefit is partially covered as it excludes upgrades, non-Medicare-covered stays, and additional psychiatric days, though unlimited additional acute care days are covered with no copay.
Outpatient Services See details
Outpatient services covered by UHC Dual Complete FL-D005 (Regional PPO D-SNP) feature no copayments, though prior authorization is required for most services. Patients will pay a 0% to 20% coinsurance for outpatient hospital, ambulatory surgical center, and substance abuse services, and a 20% coinsurance for observation and outpatient blood services.
Partial Hospitalization See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by UHC Dual Complete FL-D005 (Regional 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 feature a copay ranging from $0 to $40 with no coinsurance, while worldwide emergency, urgent, and transportation services are available with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the UHC Dual Complete FL-D005 (Regional PPO D-SNP) feature no copays, with coinsurance ranging from 0% to 20% for primary care, specialist, and mental health services. Physical, occupational, and speech therapies require no copay and 20% coinsurance, telehealth and opioid treatments have no copay and no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by UHC Dual Complete FL-D005 (Regional PPO D-SNP), featuring no copays and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, diabetes training, fitness benefits, home safety devices, weight management, caregiver support, and in-home support. A 20% coinsurance and no copay apply to digital rectal exams and post-welcome visit EKGs, while uncovered services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are covered by UHC Dual Complete FL-D005 (Regional PPO D-SNP) with no copays or coinsurance, though some services are not covered. Covered benefits include one routine hearing exam per year and up to two prescription or OTC hearing aids every two years with a $1,500 maximum limit, while fitting and evaluation exams, along with inner-ear, outer-ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision Services are covered by UHC Dual Complete FL-D005 (Regional PPO D-SNP) with no copay, no coinsurance, and no deductible, though the benefit is only partially covered. One routine eye exam is covered per year (prior authorization required), and a $150 annual maximum applies to covered contact lenses and combined eyeglasses (lenses and frames), while other eye exam services, individual eyeglass lenses, and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by UHC Dual Complete FL-D005 (Regional PPO D-SNP), featuring Medicare-covered dental services with no copay and a 20% coinsurance, and other dental services with no copay and no coinsurance up to a $1,500 annual limit. While most preventive and comprehensive services are covered under this plan, implant services and orthodontics are not covered.
Home Infusion bundled Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs—including chemotherapy, radiation, and insulin—subject enrollees to no coinsurance to 20% coinsurance, with insulin also requiring a $35 copay.
Dialysis Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers diagnostic and radiological services with prior authorization, offering lab services with no copay and diagnostic tests with a copay and a minimum 20% coinsurance. Covered radiological services require no copays, with diagnostic radiology starting at no coinsurance, while therapeutic radiology and outpatient X-rays require a minimum 20% coinsurance.
Home Health Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under UHC Dual Complete FL-D005 (Regional PPO D-SNP) with no copay and a 20% coinsurance, and prior authorization is required. While some services are covered, specific sub-services such as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) provides partially covered Skilled Nursing Facility (SNF) services with no copay and no coinsurance, though prior authorization is required. While the plan does not require a three-day prior hospital stay for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
UHC Dual Complete FL-D005 (Regional PPO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization is required for the meal benefit, and acupuncture is not covered.
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