UHC Dual Complete AR-S2 (PPO D-SNP)

4.5 out of 5 stars
$0.00
Monthly Premium

UHC Dual Complete AR-S2 (PPO D-SNP) is a PPO D-SNP plan offered by UnitedHealthcare

Plan ID: H2001-065

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 Dual Complete AR-S2 (PPO D-SNP) - H2001-065 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 $615
Out of Pocket Max In-Network: $0
Out-of-Network: 0
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit
Routine Annual Physical Exam: $0 copay$ 1 per year
Specialty Doctor Visit
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $0
Prior Authorization Required for Doctor Specialty Visit
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:
Copayment for Acute Hospital Services per Stay $0 or $1800
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

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 $0
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 $0% or$ 20%
Coinsurance for Medicare Covered Ambulance Services - Air $0% or$ 20%

Health Care Services and Medical Supplies

UHC Dual Complete AR-S2 (PPO D-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
In-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $0
Prior Authorization Required for Chiropractic Services

Out-of-Network:

Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 0% or 30%
Diabetes Supplies, Training, Nutrition Therapy and Monitoring

Out-of-Network:

Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 0% or 20%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 0% or 20%
Durable Medical Equipment (DME)

Out-of-Network:

Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 0% or 20%
Diagnostic Tests, Lab and Radiology Services, and X-Rays

Out-of-Network:

Diagnostic Procedures/Tests Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests
0% or 40%
Copayment for Medicare Covered Lab Services
$0
Coinsurance for Medicare Covered Diagnostic Radiological Services 0% or 40%
Coinsurance for Medicare Covered Therapeutic Radiological Services 0% or 20%
Coinsurance for Medicare Covered Outpatient X-Ray Services 0% or 40%
Home Health Care

Out-of-Network:

Home Health Services:
Copayment for Medicare Covered Home Health $0
Mental Health Inpatient Care

Out-of-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital per Stay $0 or $1800
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
In-Network:

Outpatient Mental Health Services:
Copayment for Medicare-covered Individual Sessions $0
Copayment for Medicare-covered Group Sessions $0
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0
Prior Authorization Required for Outpatient Hospital Services
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 Observation Services:
Copayment for Medicare Covered Observation Services $0
Prior Authorization Required for Outpatient Observation Services
Benefit Details - General 9a2 Note - NOTE ON OBSERVATION SERVICES: Benefit category includes both the facility and professional component.

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0
Prior Authorization Required for Ambulatory Surgical Center Services
Benefit Details - General 9b Note - NOTE ON ASC SERVICES: Benefit category 9b includes both the facility and professional component.Benefit Details - General 9b Note - NOTE ON COST SHARING RANGE FOR ASC Services: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.
Outpatient Substance Abuse Care

Out-of-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 0% or 30%
Coinsurance for Medicare Covered Group Sessions 0% or 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:
Copayment for Medicare-covered Individual Sessions $0
Copayment for Medicare-covered Group Sessions $0
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
In-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $0
Copayment for Routine Foot Care $0
  • Maximum 6 visits every year
Prior Authorization Required for Podiatry Services

Out-of-Network:

Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 0% or 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 0% or 40%

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
$200 allowance every year 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: $2,500 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
In-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
Tobacco use cessation
Yearly "Wellness" visit

Prescription Drug Costs and Coverage

The UHC Dual Complete AR-S2 (PPO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $615 (excludes Tiers 1) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $615 (excludes Tiers 1)
Preferred Generic
  • Standard retail $0.00
  • Standard mail order N/A
Annual Drug Deductible $615 (excludes Tiers 1)
Preferred Generic
  • Standard retail N/A
  • Standard mail order N/A
Annual Drug Deductible $615 (excludes Tiers 1)
Preferred Generic
  • Standard retail $0.00
  • Standard mail order $0.00
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