UHC Complete Care Support MI-3 (PPO C-SNP)

3.5 out of 5 stars

^$8.80

Monthly Premium

UHC Complete Care Support MI-3 (PPO C-SNP) is a PPO C-SNP plan offered by UnitedHealthcare

Plan ID: H0294-048

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 MI-3 (PPO C-SNP) - H0294-048 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.

^$8.80

Monthly Premium

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$615
Out of Pocket Max	In-Network: $6700 Out-of-Network: 10100
Initial Coverage Limit	$0
Catastrophic Coverage Limit	$2100
Primary Care Doctor Visit	Routine Annual Physical Exam: $0 copay$ 1 per year
Specialty Doctor Visit	$45 copay
Inpatient Hospital Care	Out-of-Network: Acute Hospital Services: $455 per day for days 1 to 6 $0 per day for days 7 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	$50 copay per visit ($0 copay when outside of the United States)
Emergency Room Visit	Emergency Care: Copayment for Emergency Care $130 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	In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $275 Air Ambulance: Copayment for Air Ambulance Services $275 Prior Authorization Required for Air Ambulance

Health Care Services and Medical Supplies

UHC Complete Care Support MI-3 (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 $15 In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 Prior Authorization Required for Chiropractic Services
Diabetes Supplies, Training, Nutrition Therapy and Monitoring	Out-of-Network: Diabetic Supplies and Services: Coinsurance for Medicare Covered Diabetic Supplies 50% Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 50%
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 $40 Copayment for Medicare Covered Lab Services $0 Copayment for Medicare Covered Diagnostic Radiological Services $0 to $260 Coinsurance for Medicare Covered Therapeutic Radiological Services 20% Copayment for Medicare Covered Outpatient X-Ray Services $25
Home Health Care	Out-of-Network: Home Health Services: Coinsurance for Medicare Covered Home Health 50%
Mental Health Inpatient Care	In-Network: Psychiatric Hospital Services: $455 per day for days 1 to 5 $0 per day for days 6 to 90 Prior Authorization Required for Psychiatric Hospital Services 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 $0 to $455 Copayment for Medicare Covered Ambulatory Surgical Center Services $0 to $455 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	Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $25 Copayment for Medicare Covered Group Sessions $15 Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services. 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.
Over-the-counter (OTC) Items	Out-of-Network: Over-The-Counter (OTC) Items Services: Copayment for Non-Medicare Covered Over-The-Counter (OTC) Items $0
Podiatry Services	$45 copay 6 visits per year Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $45
Skilled Nursing Facility Care	In-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $218 per day for days 21 to 100 Prior Authorization Required for Skilled Nursing Facility Services

Dental Benefits

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

Coverage	Cost
Dental Care	Out-of-Network: Preventive Dental Services: Coinsurance for Medicare Covered Preventive Dental 20%

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 $300 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: Copayment for Medicare Covered Medicare-covered Preventive Services $0

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