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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 2025, 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 2025.
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 $43.00. 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 $420.00 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) plan has an enhanced alternative drug benefit. The plan has a deductible of $420.00. During the initial coverage phase, you will pay a copay for your prescriptions. For preferred generic drugs, there is no copay at preferred pharmacies, and a $15.00 copay at standard pharmacies. For standard generic drugs, there is a $47.00 copay at standard pharmacies. For preferred brand drugs, there is a $100.00 copay. Non-preferred drugs have a 28% coinsurance. After your yearly out-of-pocket drug costs reach $2000.00, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The UHC Complete Care AM-1 (Regional PPO C-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and emergency services have copays as well. You'll find no copays for primary care visits, preventive services, and hearing exams. The plan also provides coverage for services like home health, and skilled nursing facilities, with copays and coinsurance applying to some services. Additionally, there are benefits for vision and dental services, as well as medical equipment and supplies, though some services may require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits include acute and psychiatric care, with a $425 copay for days 1-5, and no copay for days 6-90. Additional days for inpatient hospital-acute have no copay, while non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $425, observation services have a $425 copay, ambulatory surgical center services have no copay, individual outpatient substance abuse sessions have a copay between $0 and $25, group outpatient substance abuse sessions have a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the UHC Complete Care AM-1 (Regional PPO C-SNP) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance Services are covered by the UHC Complete Care AM-1 (Regional PPO C-SNP) plan, with no coinsurance. Ground and Air Ambulance Services have a copay of $290.00. Transportation Services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by UHC Complete Care AM-1 (Regional PPO C-SNP). Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $55; there is no coinsurance for either. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay and no coinsurance.
Primary Care See details
Primary Care services include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $0 and $45, Physician Specialist Services with a copay between $0 and $50, Mental Health Specialty Services with a copay, Podiatry Services with no copay, Other Health Care Professional services with a copay between $0 and $50, Psychiatric Services with a copay, Physical Therapy and Speech-Language Pathology Services with a copay between $0 and $50, Additional Telehealth Benefits with no copay, and Opioid Treatment Program Services with no copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services, some of which have a copay. The plan also covers kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are partially covered, but not for inner ear, outer ear, or over the ear aids. OTC hearing aids have a copay between $99 and $829.
Vision Services See details
Vision services include eye exams with no copay and routine eye exams with no copay for one visit every year. Eyewear benefits are also covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services include Medicare Dental Services with 20% coinsurance, Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services with no copay. Other Dental Services, Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, and Oral and Maxillofacial Surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the UHC Complete Care AM-1 (Regional PPO C-SNP) plan. The plan requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and prior authorization, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay, and Diabetic Equipment benefits require prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $45 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by the UHC Complete Care AM-1 (Regional PPO C-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the specific sub-services of Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UHC Complete Care AM-1 (Regional PPO C-SNP) plan, with prior authorization required. For days 1-20, there is no copay, while days 21-100 have a $203 copay; however, additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include a meal benefit with no copay. However, acupuncture, over-the-counter items, 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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