D-SNP Plan Costs & Benefits

UnitedHealthcare Dual Complete Plan 1 is an HMO-POS (point-of-sale) plan. HMO-POS plans offer the same features as a Health Maintenance Organization (HMO) plan, however, there is one major difference. HMO-POS plans allow members to access healthcare providers outside the plan's network to receive some or all of their services. In most cases, a member will need to get a referral from their physician to go out of the plan's network. Plus, there are separate deductibles for in-network and out-of-network services.

Costs vary widely from plan to plan. It is beneficial to compare costs, including premiums, deductibles, and copays, and apply them to your personal situation.

Healthcare Service	Member Cost
Health plan deductible	$0
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)	$8,300 In-network
Doctor Visits
Primary (In-Network)	$0 copay
Wellness programs (e.g., fitness, nursing hotline)	Covered
Preventive care	$0 copay
Mental Health Services
Outpatient individual therapy visit (In-Network)	$0 copay (authorization required)
Outpatient individual therapy visit with a psychiatrist (In-Network)	$0 copay (authorization required)
Inpatient hospital - psychiatric (In-Network)	$0 copay (authorization required)
Outpatient group therapy visit (In-Network)	$0 copay (authorization required)
Outpatient group therapy visit with a psychiatrist (In-Network)	$0 copay (authorization required)
Rehabilitation Services
Physical therapy and speech and language therapy visit (In-Network)	$0 copay (authorization required)
Medical Equipment / Supplies
Durable medical equipment (e.g., wheelchairs, oxygen) (In-Network)	$0 copay (authorization required)
Diabetes supplies (In-Network)	$0 copay (authorization required)
Diagnostic Procedures / Lab Services / Imaging
Outpatient x-rays (In-Network)	$0 copay (authorization required)
Diagnostic radiology services (e.g., MRI) (In-Network)	$0 copay (authorization required)
Diagnostic tests and procedures (In-Network)	$0 copay (authorization required)
Medicare Part B Drugs
Chemotherapy (In-Network)	$0 copay (authorization required)
Foot Care (podiatry Services)
Routine foot care (In-Network)	$0 copay (authorization required, limits may apply)
Hearing
Hearing aids (In-Network)	$0 copay (authorization required, limits may apply)
Fitting/evaluation	Not covered
Preventive Dental
Dental x-ray(s) (Out-of-Net)	$0 copay (limits may apply)
Oral exam (Out-of-Net)	$0 copay (limits may apply)
Oral exam (In-Network)	$0 copay (limits may apply)
Cleaning (Out-of-Net)	$0 copay (limits may apply)
Dental x-ray(s) (In-Network)	$0 copay (limits may apply)
Fluoride treatment (Out-of-Net)	$0 copay (limits may apply)
Cleaning (In-Network)	$0 copay (limits may apply)
Comprehensive Dental
Diagnostic services (In-Network)	$0 copay (authorization required, limits may apply)
Endodontics (Out-of-Net)	$0 copay (authorization required, limits may apply)
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network)	$0 copay (authorization required, limits may apply)
Restorative services (Out-of-Net)	$0 copay (authorization required, limits may apply)
Diagnostic services (Out-of-Net)	$0 copay (authorization required, limits may apply)
Endodontics (In-Network)	$0 copay (authorization required, limits may apply)
Prosthodontics, other oral/maxillofacial surgery, other services (Out-of-Net)	$0 copay (authorization required, limits may apply)
Restorative services (In-Network)	$0 copay (authorization required, limits may apply)
Periodontics (Out-of-Net)	$0 copay (authorization required, limits may apply)
Periodontics (In-Network)	$0 copay (authorization required, limits may apply)
Non-routine services (In-Network)	$0 copay (authorization required, limits may apply)
Extractions (Out-of-Net)	$0 copay (authorization required, limits may apply)
Extractions (In-Network)	$0 copay (authorization required, limits may apply)
Vision
Contact lenses (In-Network)	$0 copay (limits may apply)
Eyeglass frames	Not covered
Eyeglasses (frames and lenses) (In-Network)	$0 copay (limits may apply)
Other	Not covered
Upgrades	Not covered
Routine eye exam (In-Network)	$0 copay (authorization required, limits may apply)
Emergency Care / Urgent Care
Urgent care	$0 copay
Ground ambulance	$0 copay
Inpatient hospital coverage	$0 copay
Outpatient hospital coverage	$0 copay
Skilled Nursing Facility	$0 copay
Optional supplemental benefits	No

Prescription Costs & Benefits

A basic benefit Part D plan is bundled with this health plan. This simply means that UnitedHealthcare Dual Complete Plan 1 covers the minimum amount required by Medicare, whereas enhanced benefit plans cover more of the overall costs and may include more benefits.

Prescription Drug Plan Premium

Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.

Prescription Drug Plan Deductible

The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before UnitedHealthcare begins paying its share.

Prescription Drug Plan Out-of-Pocket Costs

In addition to the plan's monthly premium and deductible, UnitedHealthcare Dual Complete Plan 1 has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.

CMS 5-Star Rating

Each year Medicare rates D-SNP plans, like UnitedHealthcare Dual Complete Plan 1, in nine categories. Medicare's plan ratings help consumers understand the quality of care and service they can expect if they qualify and choose to enroll.

Do You Qualify to Join UnitedHealthcare Dual Complete Plan 1?

Unfortunately, not everyone on Medicare will qualify to join UnitedHealthcare Dual Complete Plan 1. To join a 2023 Medicare Special Needs Plan in Cecil County, Maryland you must be eligible for both Medicare and Medicaid. To qualify for Medicare, you must be age 65 or older. People with SSDI benefits for a disability qualify after 24 months.

Maryland Medicaid eligibility is based on your income and assets. Here are Maryland's Medicaid thresholds.

People with Medicare that do not qualify to join UnitedHealthcare Dual Complete Plan 1, or another SNP plan, are encouraged to explore Medicare Advantage plans in Cecil County.

Contact UnitedHealthcare

The Medicare SNP Plans for Cecil County, Maryland information on this page originates from Medicare.gov and was last updated by All Medicare on February 2, 2023.