UHC Dual Complete VA-V001 (HMO-POS D-SNP)

by UnitedHealthcareⓇ

2026 Medicare-Medicaid Dual Eligible D-SNP plan available in Virginia

Plan ID H2445-004-0

Additional coverage:

RxHearingVisionDental

Medicare-Medicaid Dual Eligible D-SNP HMO

Monthly plan premium $25 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $3,600 / yr

Drug deductible $615 / yr

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Plan Overview

UHC Dual Complete VA-V001 (HMO-POS D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Virginia and offered by the health insurance company UnitedHealthcareⓇ. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name UHC Dual Complete VA-V001 (HMO-POS D-SNP)

Insurance Carrier UnitedHealthcareⓇ

Plan Type Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)

Network Type HMO

Cost Summary

UHC Dual Complete VA-V001 (HMO-POS D-SNP) has a monthly premium cost of $25 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $3,600. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $25 / mo

Health portion of premium $0

Drug portion of premium $25

Annual Deductible $0 / yr

Max Out-of-Pocket · in-network $3,600 / yr

Primary doctor visit $0 copay

Specialist visit $0-$40 copay

ER visit $150 copay

Ambulance $275 copay

Additional Benefits and Coverage

UHC Dual Complete VA-V001 (HMO-POS D-SNP) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. UHC Dual Complete VA-V001 (HMO-POS D-SNP) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage Yes

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Limited coverage

Home & bathroom safety devices Limited coverage

Meals for short duration Limited coverage

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay

Specialist visit In-network: $0-$40 copay
Out-of-network: $0-$40 copay

Tests, labs & imaging

Diagnostic tests & procedures In-network: $45 copay
Out-of-network: $45 copay

Lab services In-network: $0 copay
Out-of-network: $0 copay

Diagnostic radiology services (like MRI) In-network: $0-$250 copay
Out-of-network: $0-$250 copay

Outpatient x-rays In-network: $25 copay
Out-of-network: $25 copay

Emergency care $150 copay

Urgent care $0-$65 copay

Hospital Services

Inpatient hospital coverage In-network:
  Tier 1
  $475 per day for days 1-4
  $0 per day for days 5-90
  $0 per stay

Outpatient hospital coverage In-network: $0-$475 copay
Out-of-network: $0-$475 copay

Skilled nursing facility

Skilled nursing facility In-network:
  Tier 1
  $0 per day for days 1-20
  $218 per day for days 21-100
Out-of-network:
  $ per stay

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: $275 copay
Out-of-network: $275 copay

Therapy services

Occupational therapy visit In-network: $40 copay
Out-of-network: $40 copay

Physical therapy & speech & language therapy visit In-network: $40 copay
Out-of-network: $40 copay

Mental health services

Outpatient group therapy with a psychiatrist In-network: $15 copay
Out-of-network: $15 copay

Outpatient individual therapy with a psychiatrist In-network: $0-$25 copay
Out-of-network: $0-$25 copay

Outpatient group therapy visit In-network: $15 copay
Out-of-network: $15 copay

Outpatient individual therapy visit In-network: $0-$25 copay
Out-of-network: $0-$25 copay

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay

Prescription drugs (Part D benefits)

Drug tier standard retail · 1-month supply Initial coverage Catastrophic

Preferred Generic $0.00 copay $0 copay

Generic 25% coinsurance $0 copay

Preferred Brand 25% coinsurance $0 copay

Non-Preferred Drug 25% coinsurance $0 copay

Specialty Tier 25% coinsurance $0 copay

Part B drugs

Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation Not covered

Hearing aids - prescription In-network: $199-$1249 copay
Out-of-network: $199-$1249 copay

Hearing aids - over the counter In-network: $199-$829 copay
Out-of-network: $199-$829 copay

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: $0 copay

Cleaning In-network: $0 copay
Out-of-network: $0 copay

Fluoride treatment In-network: $0 copay
Out-of-network: $0 copay

Dental x-rays In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Endodontics In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Periodontics In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Prosthodontics, removable In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Prosthodontics, fixed In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Maxillofacial prosthetics In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Implant services Not covered

Oral and maxillofacial surgery In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Orthodontics Not covered

Adjunctive general services In-network: 50% coinsurance
Out-of-network: 50% coinsurance

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) Not covered

Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay

Upgrades Not covered

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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