UHC Dual Complete UT-S001 (PPO D-SNP) - 2024 UnitedHealthcare (2024)

Table of Contents
Locations Plan Overview Premium Breakdown Drug Info Part D Premium Reduction Initial Coverage Phase Gap Coverage Phase Catastrophic Coverage Phase Additional Benefits Health plan deductible Other health plan deductibles? Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) Optional supplemental benefits Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions? Outpatient hospital coverage Doctor visits Preventive care Emergency care/Urgent care Diagnostic procedures/lab services/imaging Hearing Preventive dental Comprehensive dental Vision Rehabilitation services Ground ambulance Transportation Foot care (podiatry services) Medical equipment/supplies Wellness programs (e.g., fitness, nursing hotline) Medicare Part B drugs Inpatient hospital coverage Mental health services Skilled Nursing Facility FAQs References

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UHC Dual Complete UT-S001 (PPO D-SNP) - 2024 UnitedHealthcare (1) (4 / 5)

UHC Dual Complete UT-S001 (PPO D-SNP)is a Medicare Advantage (Part C) Special Needs Plan by UnitedHealthcare.

This page features plan details for 2024 UHC Dual Complete UT-S001 (PPO D-SNP)H0271 – 038 – 0 available in Select Counties in Utah.

IMPORTANT: This page has been updated with plan and premium data for 2024.

Locations

Beaver County, Utah

Box Elder County, Utah

Cache County, Utah

Click to see more locations

Plan Overview

UHC Dual Complete UT-S001 (PPO D-SNP)offers the following coverage and cost-sharing.

Special Needs Plan Type:Dual-Eligible
Conditions Covered:
See Also
Utah 2024 UHC Dual Complete UT-S001 (PPO D-SNP)
Insurer:UnitedHealthcare
Health Plan Deductible:$0.00
MOOP:$13,300 In and Out-of-network
$8,850 In-network
Drugs Covered:Yes

Please Note:

  • This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Contact the plan for details.
  • Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Look on the Extra Help letters you get, or contact the plan to find out your exact costs.

Ready to sign up for UHC Dual Complete UT-S001 (PPO D-SNP)?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Premium Breakdown

UHC Dual Complete UT-S001 (PPO D-SNP)has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium.The following is a breakdown of your monthly premium with Part B costs included.

Part BPart CPart DPart B Give BackTotal
$174.70$0.00$0.00$0.00$174.70

Please Note:

  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

UHC Dual Complete UT-S001 (PPO D-SNP)provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible:$545.00
Initial Coverage Limit:$5,030.00
Catastrophic Coverage Limit:$8,000.00
Drug Benefit Type:Basic
Additional Gap Coverage:No
Formulary Link:Formulary Link

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

NOTE: The Inflation Reduction Act of 2022 has expanded full subsidy eligibility under the LIS program to individuals with incomes up to 150% of the Federal Poverty Level. People who qualify for Extra Help generally will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.

Initial Coverage Phase

After you pay your $545.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00. Once you reach that amount, you will enter the next coverage phase.

30 Day

60 Day

90 Day

30 Day

60 Day

90 Day

Gap Coverage Phase

After your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00, you will pay no more than the amounts below for any drug tier until you reach $8,000.00.

30 Day

90 Day

30 Day

90 Day

Tier Cost
All other tiers (Generic)25%
All other tiers (Brand-name)25%

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000.00, you pay nothing for Medicare Part D covered drugs.

Additional Benefits

UHC Dual Complete UT-S001 (PPO D-SNP)also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network No

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$13,300 In and Out-of-network
$8,850 In-network

Optional supplemental benefits

No

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-network No

Outpatient hospital coverage

In-network $0 copay (Authorization is required.) (Referral is not required.)
out-of-network 40% coinsurance per visit (Authorization is required.) (Referral is not required.)

Doctor visits

In-network Primary$0 copay (Not applicable.) (Not applicable.)
out-of-network Primary40% coinsurance per visit (Not applicable.) (Not applicable.)
In-network Specialist$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Specialist40% coinsurance per visit (Authorization is required.) (Referral is not required.)

Preventive care

In-network $0 copay (Authorization is not required.) (Referral is not required.)
out-of-network 0-40% coinsurance (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$0 copay (Not applicable.) (Not applicable.)
Urgent care$0 copay (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

In-network Diagnostic tests and procedures$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic tests and procedures40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Lab services$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Lab services$0 copay (Authorization is required.) (Referral is not required.)
In-network Diagnostic radiology services (e.g., MRI)$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic radiology services (e.g., MRI)40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient x-rays$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient x-rays40% coinsurance (Authorization is required.) (Referral is not required.)

Hearing

In-network Hearing exam$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Hearing exam40% coinsurance (Authorization is required.) (Referral is not required.)
Fitting/evaluationNot covered (There are no limits.) (Not applicable.) (Not applicable.)
In-network Hearing aids$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Hearing aids$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Preventive dental

In-network Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Fluoride treatment$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Fluoride treatment$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Comprehensive dental

In-network Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Endodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Endodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Vision

In-network Routine eye exam$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Routine eye exam40% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
OtherNot covered (There are no limits.) (Not applicable.) (Not applicable.)
In-network Contact lenses$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Contact lenses$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglass framesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Eyeglass lensesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
UpgradesNot covered (Not applicable.) (Not applicable.)

Rehabilitation services

In-network Occupational therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Occupational therapy visit40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Physical therapy and speech and language therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Physical therapy and speech and language therapy visit40% coinsurance (Authorization is required.) (Referral is not required.)

Ground ambulance

In-network $0 copay (Not applicable.) (Not applicable.)
out-of-network 20% coinsurance (Not applicable.) (Not applicable.)

Transportation

In-network $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Foot care (podiatry services)

In-network Foot exams and treatment$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Foot exams and treatment40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Routine foot care$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Medical equipment/supplies

In-network Durable medical equipment (e.g., wheelchairs, oxygen)$0 copay (Authorization is required.) (Not applicable.)
out-of-network Durable medical equipment (e.g., wheelchairs, oxygen)40% coinsurance per item (Authorization is required.) (Not applicable.)
In-network Prosthetics (e.g., braces, artificial limbs)$0 copay (Authorization is required.) (Not applicable.)
out-of-network Prosthetics (e.g., braces, artificial limbs)40% coinsurance per item (Authorization is required.) (Not applicable.)
In-network Diabetes supplies$0 copay (Authorization is required.) (Not applicable.)
out-of-network Diabetes supplies40% coinsurance per item (Authorization is required.) (Not applicable.)

Wellness programs (e.g., fitness, nursing hotline)

Covered (Authorization is not required.) (Referral is not required.)

Medicare Part B drugs

In-network Chemotherapy$0 copay (Authorization is required.) (Not applicable.)
out-of-network Chemotherapy0-40% coinsurance (Authorization is required.) (Not applicable.)
In-network Other Part B drugs$0 copay (Authorization is required.) (Not applicable.)
out-of-network Other Part B drugs0-40% coinsurance (Authorization is required.) (Not applicable.)
In-network Part B Insulin drugs$0 copay (Authorization is required.) (Not applicable.)
out-of-network Part B Insulin drugs0-40% coinsurance (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

In-network $0 copay (Authorization is required.) (Referral is not required.)
out-of-network 40% per stay (Authorization is required.) (Referral is not required.)

Mental health services

In-network Inpatient hospital – psychiatric$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Inpatient hospital – psychiatric40% per stay (Authorization is required.) (Referral is not required.)
In-network Outpatient group therapy visit with a psychiatrist$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient group therapy visit with a psychiatrist40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient individual therapy visit with a psychiatrist$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient individual therapy visit with a psychiatrist40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient group therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient group therapy visit40% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient individual therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient individual therapy visit40% coinsurance (Authorization is required.) (Referral is not required.)

Skilled Nursing Facility

In-network $0 copay (Authorization is required.) (Referral is not required.)
out-of-network 40% per stay (Authorization is required.) (Referral is not required.)

Ready to sign up for UHC Dual Complete UT-S001 (PPO D-SNP)?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Table of Contents

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UHC Dual Complete UT-S001 (PPO D-SNP) - 2024 UnitedHealthcare (2024)

FAQs

Is UnitedHealthcare dual complete the same as Medicare Advantage? ›

As a Medicare Advantage plan, UHC Dual Complete plans can also cover benefits that Original Medicare doesn't cover, such as hearing, vision, dental and prescription drug coverage covered by Medicare Part D.

Continue Reading ›
What is the difference between Medicare and UHC Medicare Advantage? ›

Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).

Know More ›
How many Medicare Advantage members does United have? ›

In 2023, UnitedHealthcare accounted for 29% of the Medicare Advantage market, or 8.9 million members, according to a report from KFF, a health policy nonprofit.

Get More Info Here ›
Is UnitedHealthcare Dual Complete legit? ›

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.

Tell Me More ›
What are the benefits of UnitedHealthcare Dual Complete? ›

UHC Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams.

Get More Info ›
What is the disadvantage of UnitedHealthcare? ›

Medicare Advantage monthly costs

AARP/UnitedHealthcare is a poor choice for PFFS plans. PFFS plans aren't a popular choice since they are usually expensive and can limit your choice of doctors. For these plans, UnitedHealthcare has high prices, low ratings and limited availability.

Learn More Now ›
Is UnitedHealthcare a good medicare supplement? ›

UnitedHealthcare is the largest provider of Medicare Supplement insurance nationwide and is financially stable, according to Moody's and AM Best. It provides a wide variety of Medigap plans in all 50 states and Washington, D.C. at competitive prices and with free or low-cost add-ons.

Tell Me More ›
What is the most highly rated Medicare Advantage Plan? ›

What is the best Medicare Advantage plan? Humana has the best Medicare Advantage plans in 2024 for most people because of its high ratings, good benefits and plans with no monthly cost. AARP/UnitedHealthcare is a good choice for its extra benefits, and Kaiser Permanente stands out for its outstanding customer service.

Tell Me More ›
Why are people leaving Medicare Advantage plans? ›

Tens of thousands of Medicare Advantage beneficiaries in California, for instance, had to scramble to switch their insurance or their providers when health care system Scripps Health announced that two of its medical groups would no longer take Medicare Advantage in 2024.

Discover More Details ›
What is the best Medicare insurance for seniors? ›

The “Best Medicare Advantage Plan Companies of 2024” are as follows:
  • 2024 Best Overall Medicare Advantage Plan Company: Humana.
  • 2024 Best Company for Member Experience: Humana.
  • 2024 Best Company for Low Premium Plan: Humana.
  • 2024 Best Company for Drug Plan Ratings: United Healthcare.
Oct 20, 2023

Learn More ›

What changes are coming to United Healthcare in 2024? ›

On January 1, 2024, our plan name changes from UnitedHealthcare® Dual Choice (PPO D-SNP) to UHC Dual Choice DC-S001 (PPO D-SNP). We will mail you a new UnitedHealthcare enrollee ID card.

View Details ›
What are the other names for Medicare Advantage plans? ›

Medicare Advantage (also known as Part C)

In most cases, you'll need to use doctors who are in the plan's network. Plans may have lower out-of-pocket costs than Original Medicare. Plans may offer some extra benefits that Original Medicare doesn't cover—like vision, hearing, and dental services.

Discover More ›
What are the two types of Medicare Advantage plans? ›

Preferred Provider Organizations (PPOs) Special Needs Plans (SNPs)

Keep Reading ›
Can you have Medicare and UnitedHealthcare at the same time? ›

Yes — but you have to enroll in Medicare Part A and/or Part B. For a Medicare Advantage (Part C) plan, you must have both Medicare Part A and Part B to apply.

Discover More ›
Is AARP Medicare Advantage the same as UnitedHealthcare? ›

AARP Medicare Supplement plans are insured by UnitedHealthcare Insurance Company and endorsed by AARP.

Keep Reading ›

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