UHC Dual Complete IN-S002 (PPO D-SNP) H0271-005-000 2024 Plan Details and Costs (2024)

UHC Dual Complete IN-S002 (PPO D-SNP) is a PPO D-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare

Plan ID: H0271-005-000

Indiana Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Indiana Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

Coverage Details
Monthly plan premium$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$8,850.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visitIn-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0.00

Specialty doctor visit

Doctor Specialty Visit:
Coinsurance for Medicare Covered Physician Specialist Office Visit 40%

Inpatient hospital care
Copayment for Acute Hospital Services per Stay $0.00
Urgent care
Urgent Care:
Copayment for Urgent Care $0.00

Benefit Details - General 4b Note - NOTE ON COST SHARING RANGE FOR URGENTLY NEEDED SERVICES: $0 copayment applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services.

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0.00

Emergency room visit
Emergency Care:
Copayment for Emergency Care $0.00
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $0.00
Copayment for Worldwide Emergency Transportation $0.00

Ambulance transportation

Ambulance Services:
Coinsurance for Medicare Covered Ambulance Services - Ground 20%
Coinsurance for Medicare Covered Ambulance Services - Air 20%

Health Care Services and Medical Supplies

UHC Dual Complete IN-S002 (PPO D-SNP) covers a range of additional benefits. Learn more about UHC Dual Complete IN-S002 (PPO D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

Coverage Details
Chiropractic services

Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 40%

Diabetes supplies, training, nutrition therapy and monitoring

Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies and Services 40%

Durable medical equipment (DME)

Durable Medical Equipment:
Coinsurance for Medicare Covered Durable Medical Equipment 40%

Diagnostic tests, lab and radiology services, and X-rays

Outpatient Diag Procs/Tests/Lab Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests 40%
Copayment for Medicare Covered Lab Services $0.00
Coinsurance for Medicare Covered Diagnostic Radiological Services 40%
Coinsurance for Medicare Covered Therapeutic Radiological Services 40%
Coinsurance for Medicare Covered Outpatient X-Ray Services 40%

Home health careIn-Network:

Home Health Services:
Copayment for Medicare-covered Home Health Services $0.00
Prior Authorization Required for Home Health Services

Mental health inpatient careIn-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital Services per Stay $0.00
Prior Authorization Required for Psychiatric Hospital Services

Mental health outpatient careIn-Network:

Outpatient Mental Health Services:
Copayment for Medicare-covered Individual Sessions $0.00
Copayment for Medicare-covered Group Sessions $0.00
Prior Authorization Required for Outpatient Mental Health Services

Outpatient services/surgery

Outpatient Hospital and ASC Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%

Outpatient substance abuse care

Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual or Group Sessions 40%

Over-the-counter itemsIn-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0.00
Maximum Plan Benefit of $146.00 every month
Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit

Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $0.00
Copayment for Routine Foot Care $0.00

  • Maximum 4 visits every year
Prior Authorization Required for Podiatry Services
Skilled Nursing Facility (SNF) careIn-Network:

Skilled Nursing Facility Services:
$0.00 per day for days 1 to 20
$0.00 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Dental care

Medicare Covered Dental Services:
Coinsurance for Medicare Covered Comprehensive Dental 40%
Non-Medicare Covered Dental Services:
Copayment for Non-Medicare Covered Preventive Dental $0.00
Copayment for Non-Medicare Covered Comprehensive Dental $0.00

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Vision benefits

Medicare Covered Vision Services:
Coinsurance for Medicare Covered Eye Exams 40%
Coinsurance for Medicare Covered Eyewear 40%
Non-Medicare Covered Vision Services:
Coinsurance for Non-Medicare Covered Eye Exams 40%
Copayment for Non-Medicare Covered Eyewear $0.00

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Hearing benefitsIn-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $0.00
Copayment for Routine Hearing Exams $0.00

  • Maximum 1 visit every year
Prior Authorization Required for Hearing Exams

Hearing Aids:
Copayment for Hearing Aids $0.00

  • Maximum 2 Hearing Aids every year
Maximum Plan Benefit of $3600.00 every year both ears combined for in and out of network services combined
Prior Authorization Required for Hearing Aids

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

Coverage Details
Preventive services and health/wellness education programsIn-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vagin*l cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling

  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation
    Yearly "Wellness" visit

    When reviewing Indiana Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

    You may be able to find plans in your part of Indiana that offer similar benefits at similar or lower prices than the plan above. Call 1-855-580-1854 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

    Plan Documents

    Links to plan documents
    • Summary of benefits
    • Evidence of coverage
    • Star ratings

    Indiana Counties Served

    Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur Dekalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hanco*ck Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Jennings Johnson Knox Kosciusko La Porte Lagrange Lake Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush Scott Shelby Spencer St Joseph Starke Steuben Sullivan Switzerland Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley

    We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

    Back to plans in Indiana

    UHC Dual Complete IN-S002 (PPO D-SNP) H0271-005-000 2024 Plan Details and Costs (2024)


    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.

    How much UnitedHealthcare OTC benefits in 2024? ›

    You can also order by phone at 1-888-628-2770 (TTY: 711) Monday to Friday, from 9 AM to 8 PM local time or online at https://www.cvs.com/benefits. You order from a list of approved items, and it will be sent to your address. How much is my OTC benefit? You have $25 per month.

    Is Medicare Advantage the same as DSNP? ›

    ​​​​​​​​​​​​​​​​​​​Dual Eligible Special Needs Plans in California. Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage (MA) health plans which provide specialized care and wrap-around services for dual eligible beneficiaries (eligible for both Medicare and ​Medicaid).

    What is Medicare Part D UHC? ›

    Medicare Part D prescription drug plans cover the following: Types of drugs most commonly prescribed for Medicare beneficiaries as determined by federal standards. Specific brand name drugs and generic drugs included in the plan's formulary (list of covered drugs) Commercially available vaccines not covered by Part B.

    Is United Healthcare 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.

    What is dual coverage? ›

    If you have two jobs that both provide dental benefits or if you are covered by a second dental plan in addition to your own, you have what is called dual coverage. Dual coverage doesn't mean that your benefits are doubled. What it does mean is that you will likely enjoy lower out-of-pocket costs for your dental care.

    What is the disadvantage of UnitedHealthcare? ›

    Special needs plans can get pricey: While lower-priced plans are available, UnitedHealthcare also offers the highest-priced special needs plan (SNP) in 2024, so it's worth keeping an eye on the cost for plans that fit your needs.

    What food can I buy with a UnitedHealthcare OTC card? ›

    With your healthy food credits, you could buy a wide range of approved groceries, like:
    • Fruit & vegetables.
    • Frozen produce & meals.
    • Dairy products.
    • Meat & seafood.
    • Beans & legumes.
    • Pantry staples – flour, sugar, spices, etc.
    • Healthy grains – bread, cereals, pastas, etc.
    • Nutritional shakes & bars.

    What groceries can I buy with my healthy Benefits card? ›

    With your Extra Benefits Card, you have a benefit amount to spend each month on approved healthy foods.* You can buy fruits, veggies, meat and seafood. You can also get pantry staples and healthy grains like flour, spices, bread, pasta and more! Always select credit when using the card – a PIN is never needed.

    What does ppo snp mean? ›

    Your Medicare SNP may be a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). Depending on your plan, you may need to see in-network providers to receive coverage, or have the option of going out of network. SNPs are not available everywhere.

    What are the three types of SNP plans? ›

    You meet the eligibility requirements for one of the 3 types of SNPs:
    • Dual Eligible SNP (D-SNP)
    • Chronic Condition SNP (C-SNP)
    • Institutional SNP (I-SNP)

    What is the most highly rated Medicare Advantage plan? ›

    Our Top Medicare Advantage Providers
    • Best Consumer Reputation: Blue Cross Blue Shield.
    • Best Nationwide Coverage: Humana.
    • Best Local Support Services: Aetna.
    • Largest Provider Network: UnitedHealthcare.
    • Best Additional Benefits: Cigna.
    • Best Overall CMS Rating: Anthem.
    Jun 3, 2024

    What is the maximum out of pocket for Medicare Part D? ›

    Out-of-pocket costs

    Health or prescription drug costs that you must pay on your own because they aren't covered by Medicare or other insurance. will be capped at $2,000, starting in 2025.

    What is not covered by Medicare Part D? ›

    There are many drugs that no Medicare plans will cover under the Part D benefit, based on national Medicare guidelines. Drugs for anorexia, weight loss, or weight gain (i.e., Xenical®, Meridia, phentermine HCl, etc.) Drugs that promote fertility (i.e., Clomid, Gonal-f, Ovidrel®, Follistim®, etc.)

    What is the best insurance for Medicare? ›

    Here's an overview of our top picks for Medicare Advantage plans:
    • Best for size of network: UnitedHealthcare Medicare Advantage.
    • Best for extra perks: Aetna Medicare Advantage.
    • Best for local support: Blue Cross Blue Shield Medicare Advantage.
    • Best for low-cost plan availability: Humana Medicare Advantage.
    May 13, 2024

    What is a dual benefit? ›

    Dual Benefits means the payment by an Open-Shop Contractor or Subcontractor into both an existing employer-sponsored benefit plans while also making required payments into a Trust Fund.

    Does United Healthcare cover oxygen? ›

    United Healthcare is a leading provider of health insurance plans that generally offers coverage for durable medical equipment (DME) that is deemed medically necessary. This coverage extends to a wide range of essential medical equipment, including wheelchairs, crutches, and oxygen equipment.

    What is primary advantage with UHC? ›

    Primary Advantage® plans

    Designed to provide employees with $0 primary and virtual care network copays and 100% network coverage for preventive care.

    What is the difference between DSNP and MMP? ›

    These plans streamline access to care through Medicare and Medicaid. But there's a key difference. With an MMP, all Medicare and Medicaid benefits are provided through 1 single health plan. With a D-SNP, members keep the same Medicaid plan and all the same Medicaid benefits as they get today.


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