UnitedHealthcare Dual Complete® (HMO SNP) H4094-001

Dual Special Needs Program (DSNP)

H4094-001

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. H4094-001

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

Benefits & Features

Dental Coverage

$1,200 toward dental services.

Protect your teeth and your gums by receiving regular dental care at no extra cost to you.

Dental coverage includes:

  • $1,200 toward your dental services.
  • Regular exams and cleanings, including fluoride treatments every 6 months.
  • Restorative services like fillings, crowns, periodontal services, extractions, dentures, root canals and more.

Every 3 months you'll receive $125 in credits to order health products through the FirstLine catalog. The mail order 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.

We can help you get to plan-sponsored locations so you can take care of your health needs. 30 one-way or 15 round trips are available at no extra cost to you.

Transportation coverage may include:

  • Rides to health providers like doctors and dentists.
  • Rides to your pharmacy.
  • Wheelchair accessible vehicles as needed.

Help protect your eyesight and health with routine eye exams at no extra cost to you.

Vision coverage includes:

  • One routine eye exam every year.
  • $0 copay for standard eyeglass lenses.
  • $200 credit toward glasses or contacts every 2 years.

$0 copay for up to 12 visits per year to help keep your feet healthy.

24-hr. NurseLine

Speak with a registered nurse anytime at no extra cost.

Additional Benefits

More benefits than Original Medicare.

Hearing Coverage

Annual exam and $1,600 every 2 years for hearing devices.

House Calls

Get a home visit from a health care practitioner at no extra cost.

No Referral Needed

Your choice of specialists within the network.

Prescription Drugs

Thousands of drugs available.

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.

Member Resources

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