UHC Complete Care Support GA-9 (PPO C-SNP)

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UHC Complete Care Support GA-9 (PPO C-SNP) is a PPO C-SNP plan offered by UnitedHealthcare

Plan ID: H1889-028

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as UHC Complete Care Support GA-9 (PPO C-SNP) - H1889-028 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.

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Georgia Counties Served

Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Catoosa Charlton Chatham Chattahoochee Chattooga Clarke Clay Clinch Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur Dodge Dooly Early Echols Effingham Elbert Emanuel Evans Fannin Floyd Franklin Gadsden Gilmer Glascock Glynn Gordon Grady Greene Habersham Hall Hancock Haralson Harris Hart Heard Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion Mcduffie Mcintosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$615
Out of Pocket Max	In-Network: $7900 Out-of-Network: 7900
Initial Coverage Limit	$0
Catastrophic Coverage Limit	$2100
Primary Care Doctor Visit	Out-of-Network: Doctor Office Visit Services: Copayment for Medicare Covered Primary Care Office Visit $20
Specialty Doctor Visit	Out-of-Network: Doctor Specialty Visit Services: Copayment for Medicare Covered Physician Specialist Office Visit $80 Note: $0 copayment applies to Medicare covered telehealth and Medicare covered remote monitoring. The higher cost share applies to all other Medicare covered services.
Inpatient Hospital Care	Out-of-Network: Acute Hospital Services: $650 per day for days 1 to 13 $0 per day for days 14 to 999 Note: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b.
Urgent Care	$40 copay per visit ($0 copay when outside of the United States)
Emergency Room Visit	Emergency Care: Copayment for Emergency Care $115 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $0 Copayment for Worldwide Emergency Transportation $0
Ambulance Transportation	Out-of-Network: Ambulance Services: Copayment for Medicare Covered Ambulance Services - Ground $275 Copayment for Medicare Covered Ambulance Services - Air $275

Health Care Services and Medical Supplies

UHC Complete Care Support GA-9 (PPO C-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage	Cost
Chiropractic Services	Out-of-Network: Chiropractic Services: Copayment for Medicare Covered Chiropractic Services $80 In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 Prior Authorization Required for Chiropractic Services
Diabetes Supplies, Training, Nutrition Therapy and Monitoring	In-Network: Diabetic Supplies and Services: Copayment for Medicare-covered Diabetic Supplies $0 Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $0
Durable Medical Equipment (DME)	Out-of-Network: Durable Medical Equipment Services: Coinsurance for Medicare Covered Durable Medical Equipment 50%
Diagnostic Tests, Lab and Radiology Services, and X-Rays	Out-of-Network: Diagnostic Procedures/Tests Services: Copayment for Medicare Covered Diagnostic Procedures/Tests $75 Copayment for Medicare Covered Lab Services $0 Copayment for Medicare Covered Diagnostic Radiological Services $360 Coinsurance for Medicare Covered Therapeutic Radiological Services 40% Copayment for Medicare Covered Outpatient X-Ray Services $50
Home Health Care	In-Network: Home Health Services: Copayment for Medicare-covered Home Health Services $0 Prior Authorization Required for Home Health Services
Mental Health Inpatient Care	Out-of-Network: Psychiatric Hospital Services: $650 per day for days 1 to 13 $0 per day for days 14 to 90 Benefit Details - General Note - NOTE ON INPATIENT SUBSTANCE ABUSE: All inpatient substance abuse and mental health care (including both care received in an acute care facility and a Medicare-certified psychiatric facility) are included in category 1b.
Mental Health Outpatient Care	Copayment for Medicare Covered Individual Sessions $25 copay
Outpatient Services / Surgery	Out-of-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $650 Copayment for Medicare Covered Ambulatory Surgical Center Services $650 Benefit Details - General 9a1 Note - NOTE ON COST SHARING RANGE FOR OUTPATIENT HOSPITAL SERVICES: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Benefit Details - General 9a1 Note - NOTE ON OUTPATIENT HOSPITAL SERVICES: Benefit category includes both the facility and professional component.
Outpatient Substance Abuse Care	In-Network: Outpatient Substance Abuse Services: Copayment for Medicare-covered Individual Sessions $0 to $25 Copayment for Medicare-covered Group Sessions $15 Prior Authorization Required for Outpatient Substance Abuse Services Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $40 Copayment for Medicare Covered Group Sessions $30 Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services.
Over-the-counter (OTC) Items	$90 credit per month for OTC products like first aid supplies, pain relievers and more, plus healthy food like fruits, vegetables and meat. Shop at thousands of participating stores, including Walmart, Walgreens and Dollar General, or at neighborhood stores near you.
Podiatry Services	$0 copay 6 visits per year Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $80
Skilled Nursing Facility Care	Out-of-Network: Skilled Nursing Facility Services: $250 per day for days 1 to 100

Dental Benefits

The following dental services are covered from in-network providers.

Coverage	Cost
Dental Care	$3,000 allowance toward covered preventive and comprehensive services. $0 copay for covered preventive services such as oral exams, routine cleanings, X-rays and fluoride 50% of the cost for all covered comprehensive services, such as fillings, crowns, root canals, extractions, bridges and dentures You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist.

Coverage

Cost

Dental Care

$3,000 allowance toward covered preventive and comprehensive services.
$0 copay for covered preventive services such as oral exams, routine cleanings, X-rays and fluoride
50% of the cost for all covered comprehensive services, such as fillings, crowns, root canals, extractions, bridges and dentures
You will have access to one of Medicare Advantage's largest dental networks, or you can choose any dentist.

Vision Benefits

The following vision services are covered from in-network providers.

Coverage	Cost
Vision Benefits	Routine Eye Exam: $0 copay 1 per year Routine Eyewear: $0 copay for standard prescription lenses $150 allowance every 2 years for 1 pair of lenses/frames or contacts.

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage	Cost
Hearing Benefits	Hearing Aids Package: $199 - $1,249 copay per device, up to 2 hearing aids per year Choose from a broad selection of OTC and brand-name prescription hearing aids through UnitedHealthcare Hearing. Access to one of the largest national networks with thousands of hearing professionals.

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage	Cost
Preventive Services and Health/Wellness Education Programs	Out-of-Network: Medicare-covered Preventive Services: Coinsurance for Medicare Covered Medicare-covered Preventive Services 0% to 40%

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