UnitedHealthcare Dual Complete® (HMO D-SNP)

Dual Special Needs Program (DSNP)

H1375-001-000

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. 

This plan gives you a choice of doctors and hospitals. Plus you get coverage for a long list of prescription drugs.

Benefits & Features

Dental Coverage

$500 toward dental services.

Protect your teeth and gums by receiving regular dental care.

Dental coverage includes:

  • Routine cleanings and periodontal maintenance.
  • Routine exams, commonly used x-rays and fluoride treatments.
  • Fillings and nitrous oxide.

Every 3 months you'll receive $50 in credits to order health products through the FirstLine Medical® catalog. The products will be delivered directly to you at no extra cost.

Catalog products may include:

  • Oral care, eye and ear care items.
  • Pain relievers, cold remedies and vitamins.
  • Thermometers, blood pressure monitors and more.

Peace of mind knowing you are still covered, even if away from home.

An emergency or urgent care need may be described as one of the following situations:

  • Critical impairment of bodily function.
  • Rapid onset of illness that requires immediate medical attention.
  • Sudden injury or medical condition that severely compromises a person's health.

Prescription drug coverage that fits your health care needs.

Prescription drug coverage may include:

  • Commonly used generic and brand name prescription drugs.
  • Get prescriptions filled at local preferred retail pharmacies.
  • Access to 30-day or 90-day supply from retail network pharmacy.

Your choice of specialists within the network.

Additional Benefits

More benefits than Original Medicare.

UnitedHealthcare® HouseCalls

Get a yearly in-home preventative care visit with a health care practitioner at no extra cost.

UnitedHealthcare Dual Complete® (HMO D-SNP)

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

Your level of extra help Monthly Premium*
100% $0.00
75% $7.50
50% $15.10
25% $22.60

*This does not include any Medicare Part B premium you may have to pay.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare of TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

Your health care needs are unique. These documents can help you make sure you get the right coverage.

Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary of Benefits, Other downloadable resources.

Downloadable Resources

Member Resources

View Available Resources