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UHC Complete Care AM-1 (Regional PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UHC Complete Care AM-1 (Regional PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UHC Complete Care AM-1 (Regional PPO C-SNP) in 2026, please refer to our full plan details page.
UHC Complete Care AM-1 (Regional PPO C-SNP) is a Regional PPO C-SNP plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in States of Arkansas and Missouri. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that UHC Complete Care AM-1 (Regional PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
UHC Complete Care AM-1 (Regional PPO C-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 Complete Care AM-1 (Regional PPO C-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 Complete Care AM-1 (Regional PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $56.00. 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 $600.00 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 $6700.00 (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 $6700.00 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 Complete Care AM-1 (Regional PPO C-SNP) offers an Enhanced Alternative drug benefit with a $600.00 annual prescription deductible. If you qualify for the low-income subsidy, your Part D premium can be reduced from $53.00 to $24.40. During the initial coverage phase, Tier 1 preferred generics cost a $15.00 copay at standard pharmacies, while Tier 2 standard generics require a 19% coinsurance and Tier 3 preferred brands require a 30% coinsurance. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase. During this phase, you pay nothing for Medicare Part D covered drugs. This coverage structure helps limit your prescription expenses and provides financial protection once the out-of-pocket threshold is met.
Additional Benefits
The UHC Complete Care AM-1 (Regional PPO C-SNP) plan offers robust coverage for essential medical services, with many benefits requiring no coinsurance. You will enjoy no copay and no coinsurance for primary care visits, routine preventive services, and home health care. For more intensive care, inpatient hospital stays require a $485 daily copay for the first few days, while emergency room visits have a $130 copay and urgent care is up to $50. Routine hearing, dental, and vision exams are covered with no copay and no coinsurance, though specialized treatments and hardware like eyeglasses are not covered. For specialized medical needs, durable medical equipment, dialysis, and certain Part B drugs require a 20% coinsurance with no copay. Diagnostic lab work is available with no copay, while other diagnostic and X-ray services require flat copays and no coinsurance.
Inpatient Hospital See details
UHC Complete Care AM-1 (Regional PPO C-SNP) partially covers inpatient hospital benefits with no coinsurance, requiring a $485 daily copay for days 1 to 5 of acute stays and days 1 to 4 of psychiatric stays, followed by no copay for remaining covered days. Non-Medicare-covered stays, upgrades for acute care, and additional days for psychiatric care are not covered, and prior authorization is required.
Outpatient Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services range from no copay to a $485 copay, observation services require a $485 daily copay, and outpatient substance abuse services range from no copay to a $25 copay.
Partial Hospitalization See details
UHC Complete Care AM-1 (Regional PPO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of up to $50 and no coinsurance, while worldwide emergency, urgent, and transportation services are provided with no copay and no coinsurance.
Primary Care See details
UHC Complete Care AM-1 (Regional PPO C-SNP) covers primary care, telehealth, podiatry, and opioid treatment services with no copay and no coinsurance. Specialist, therapy, and mental health services require copays ranging from $0 to $55 with no coinsurance, while chiropractic services are partially covered with a $15 copay and no coinsurance because routine chiropractic care is not covered.
Preventive Services See details
Preventive services are partially covered by UHC Complete Care AM-1 (Regional PPO C-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and select screenings. Additional preventive services are not covered under this plan.
Hearing Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) partially covers hearing services, offering annual routine hearing exams with no copay or coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199 to $1,249, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by UHC Complete Care AM-1 (Regional PPO C-SNP), offering one routine eye exam every year with no copay and no coinsurance. For eyewear, some services are covered, but contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades are not covered in practice.
Dental Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) partially covers dental services, offering preventive care like oral exams, cleanings, fluoride, and X-rays with no copay and no coinsurance. Medicare-covered dental services are subject to a 20% coinsurance and no copay, but restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are partially covered by UHC Complete Care AM-1 (Regional PPO C-SNP), as Part D home infusion drugs are not included in the bundle. Covered Part B chemotherapy and other drugs require no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance. Prior authorization is required, and step therapy may apply.
Dialysis Services See details
Dialysis Services are covered by UHC Complete Care AM-1 (Regional PPO C-SNP) with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by UHC Complete Care AM-1 (Regional PPO C-SNP), with prior authorization required for most services. Durable medical equipment, prosthetics, and medical supplies require a 20% coinsurance and no copay, while diabetic supplies and therapeutic shoes or inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by UHC Complete Care AM-1 (Regional PPO C-SNP) with prior authorization. Lab services have no copay, diagnostic tests require a $50 copay, and outpatient X-rays require a $25 copay, all with no coinsurance. Diagnostic radiological services range from no copay up to a $260 copay with no coinsurance, while therapeutic radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered by UHC Complete Care AM-1 (Regional PPO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under UHC Complete Care AM-1 (Regional PPO C-SNP), though some services are covered but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered in practice. Consequently, there is no copay or coinsurance for these non-covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by UHC Complete Care AM-1 (Regional PPO C-SNP), which requires prior authorization and charges no copay and no coinsurance for days 1 through 20, followed by a $218 daily copay and no coinsurance for days 21 through 100. Additional days beyond Medicare-covered SNF services are not covered.
Other Services See details
UHC Complete Care AM-1 (Regional PPO C-SNP) partially covers Other Services, offering a meal benefit for chronic illnesses with no copay and no coinsurance. Other sub-services, including acupuncture, over-the-counter items, and dual eligible SNPs, are not covered under this plan.
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