UHC Complete Care Support NM-1A (PPO C-SNP)

4.5 out of 5 stars
$0.00
Monthly Premium

UHC Complete Care Support NM-1A (PPO C-SNP) is a PPO C-SNP plan offered by UnitedHealthcare

Plan ID: H2001-042

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 NM-1A (PPO C-SNP) - H2001-042 by UnitedHealthcare as well as other Medicare Advantage plans available in your area.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $491
Out of Pocket Max In-Network: $9250
Out-of-Network: 13900
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit
Routine Annual Physical Exam: $0 copay$ 1 per year
Specialty Doctor Visit

Out-of-Network:

Doctor Specialty Visit Services:
Coinsurance for Medicare Covered Physician Specialist Office Visit $30%
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:
Coinsurance for Acute Hospital Services per Stay 20%
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

Urgent Care:
Copayment for Urgent Care $0 to $40

Note: $0 copayment applies to Medicare covered telehealth. The higher cost share applies to all other Medicare covered services.

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0
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:
Coinsurance for Medicare Covered Ambulance Services - Ground $20%
Coinsurance for Medicare Covered Ambulance Services - Air $20%

Health Care Services and Medical Supplies

UHC Complete Care Support NM-1A (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:
Coinsurance for Medicare Covered Chiropractic Services 30%
In-Network:

Chiropractic Services:
Coinsurance for Medicare-covered Chiropractic Services 20%
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 30%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 30%
Durable Medical Equipment (DME)

Out-of-Network:

Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 30%
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Diagnostic Procedures/Tests: $0 - 20% of the cost
Lab Services: $0 copay
Diagnostic Radiology Services: $0 - 20% of the cost
X-Rays: $0 - 20% of the cost
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
In-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital Services per Stay $2000
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

Out-of-Network:

Mental Health Services:
Coinsurance for Medicare Covered Individual Sessions 30%
Coinsurance for Medicare Covered Group Sessions 30%
Outpatient Services / Surgery
Outpatient Hospital Services:
Copayment for Ambulatory Surgical Center Services $0 copay - 20% of the cost
Outpatient Substance Abuse Care

Out-of-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 30%
Coinsurance 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.
In-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare-covered Individual Sessions 0% to 20%
Coinsurance for Medicare-covered Group Sessions 20%
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
$60 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 4 visits per year
Out-of-Network:

Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 30%
Skilled Nursing Facility Care
In-Network:

Skilled Nursing Facility Services:
Copayment for Skilled Nursing Facility Services per Stay $0
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 30%

Vision Benefits

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

Coverage Cost
Vision Benefits

Out-of-Network:

Eye Exams Services:
Coinsurance for Medicare Covered Eye Exams 30%
Copayment for Medicare Covered Eyewear $0

Hearing Benefits

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

Coverage Cost
Hearing Benefits
Hearing Aids Package: $1,500 allowance up to 2 hearing aids every 2 years
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 30%

Prescription Drug Costs and Coverage

The UHC Complete Care Support NM-1A (PPO C-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $491 (excludes Tiers 1 and 2) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $491 (excludes Tiers 1 and 2)
Preferred Generic
  • Standard retail $0.00
  • Standard mail order N/A
Generic
  • Standard retail $0.00
  • Standard mail order N/A
Annual Drug Deductible $491 (excludes Tiers 1 and 2)
Preferred Generic
  • Standard retail N/A
  • Standard mail order N/A
Generic
  • Standard retail N/A
  • Standard mail order N/A
Annual Drug Deductible $491 (excludes Tiers 1 and 2)
Preferred Generic
  • Standard retail $0.00
  • Standard mail order $0.00
Generic
  • Standard retail $0.00
  • Standard mail order $0.00
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