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UHC Dual Complete TX-S001 (Regional PPO D-SNP)

UnitedHealthcare
UHC Dual Complete TX-S001 (Regional PPO D-SNP) R6801-011 Plan Details
3 out of 5 stars

UHC Dual Complete TX-S001 (Regional PPO D-SNP) is a Regional PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: R6801-011

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.

$0.00
Monthly Premium

UHC Dual Complete TX-S001 (Regional PPO D-SNP) is a Regional PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: R6801-011

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.

UnitedHealthcare
UHC Dual Complete TX-S001 (Regional PPO D-SNP) R6801-011 Plan Details
3 out of 5 stars

UHC Dual Complete TX-S001 (Regional PPO D-SNP) is a Regional PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare
Plan ID: R6801-011

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.

$0.00
Monthly Premium

Texas Counties Served

El Paso Hardin Jackson Yoakum Austin Matagorda Wharton Galveston Washington Jefferson Travis Orange Frio Dawson Taylor Live Oak Lavaca Sherman Bexar Culberson Jones Comal Stonewall Blanco Collin Dallas Denton Rockwall Tarrant Guadalupe Hays San Patricio Upton Freestone Newton Walker Clay Johnson Polk Bastrop Caldwell Kinney Moore Runnels Knox Cooke Haskell Archer Bell Baylor Eastland Stephens Comanche Brown Hall Lampasas Callahan Coleman Falls Deaf Smith Williamson Hansford Milam Hutchinson Coryell Oldham Mclennan Burnet Burleson Llano Lee Hartley Dallam Concho Schleicher Menard Sutton Kerr Tom Green Edwards Reagan Carson Roberts King Harris Fort Bend Montgomery Motley Cottle San Jacinto Liberty Chambers Waller Hudspeth Gillespie Mills Mason San Saba Kendall Dona Ana Atascosa Medina Bandera Wilson Brazoria Hidalgo Grayson Van Zandt Ellis Kaufman Hunt Fannin Montague Parker Wise Somervell Hood Bosque Palo Pinto Jack Erath Hamilton La Salle Mcmullen Real Karnes Gonzales Nacogdoches Angelina Tyler Jasper Colorado Crosby Lubbock Calhoun Hockley Scurry Brazos Webb Terry Victoria Goliad Refugio De Witt Garza Martin Borden Lynn Kent Glasscock Zapata Howard Smith Bee Nolan Navarro Red River Sabine Fisher Andrews Henderson Anderson Nueces Lamar Jim Wells Delta Duval Kenedy Rains Wood Hopkins Upshur Camp Cherokee Morris Gregg Titus Franklin Aransas Midland Bowie Cass Marion Harrison Rusk Brooks Panola Kleberg Shelby Leon Limestone Jim Hogg Reeves Trinity San Augustine Pecos Houston Cameron Madison Starr Willacy Uvalde Ward Hill Irion Dimmit Maverick Ochiltree Throckmorton Wilbarger Wichita Zavala Young Terrell Crane Foard Shackelford Fayette Lipscomb Gray Parmer Swisher Dickens Jeff Davis Wheeler Hemphill Ector Hardeman Potter Robertson Randall Donley Hale Lamb Armstrong Mcculloch Briscoe Castro Kimble Bailey Val Verde Floyd Gaines Crockett Coke Collingsworth Loving Mitchell Winkler Brewster Sterling Cochran Childress Presidio Grimes

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $9350
Out-of-Network: N/A
Initial Coverage Limit $2000
Catastrophic Coverage Limit $2,000
Primary Care Doctor Visit
In-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0
Note: $0 copayment applies to Medicare covered telehealth and Medicare covered remote monitoring. The higher cost share applies to all other Medicare covered services.
Specialty Doctor Visit
In Network
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.


Out of Network

Out-of-Network:

Doctor Specialty Visit Services:
Coinsurance for Medicare Covered Physician Specialist Office Visit 0% or 20%
Note: $0 copayment applies to Medicare covered telehealth and Medicare covered remote monitoring. The higher cost share applies to all other Medicare covered services.
Prior authorization required
Inpatient Hospital Care
In Network
In-Network:

Acute Hospital Services:
Copayment for Acute Hospital Services per Stay $0
Prior Authorization Required for Acute Hospital Services
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.


Out of Network

Out-of-Network:

Acute Hospital Services:
Copayment for Acute Hospital Services per Stay $0 or $1960
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.
Prior authorization required
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
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
In Network
In-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $0

Air Ambulance:
Copayment for Air Ambulance Services $0
Prior Authorization Required for Air Ambulance


Out of Network

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%
Prior authorization required

Health Care Services and Medical Supplies

UHC Dual Complete TX-S001 (Regional 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
In-Network:
Copayment for Medicare-covered Chiropractic Services $0
Prior Authorization Required for Chiropractic Services


Out of Network

Out-of-Network:

Medicare Covered Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 0% or 20%
Prior authorization required
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In Network
In-Network:
Copayment for Medicare-covered Diabetic Supplies $0
Copayment for Medicare-covered Diabetic Therapeutic Shoes or Inserts $0


Out of Network

Out-of-Network:

Medicare Covered Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 0% or 40%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 0% or 40%
Durable Medical Eqipment (DME)
In Network
In-Network:
Copayment for Medicare-covered Durable Medical Equipment $0
Prior Authorization Required for Durable Medical Equipment


Out of Network

Out-of-Network:

Medicare Covered Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 0% or 40%
Prior authorization required
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Diagnostic Tests and Procedures:
$0 copay

Lab Services:
$0 copay

Diagnostic Radiology Services:
$0 copay

X-rays:
$0 copay
Home Health Care
In Network
In-Network:
Copayment for Medicare-covered Home Health Services $0
Prior Authorization Required for Home Health Services


Out of Network

Out-of-Network:

Medicare Covered Home Health Services:
Copayment for Medicare Covered Home Health $0
Prior authorization required
Mental Health Inpatient Care
In Network
In-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital Services per Stay $0
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.


Out of Network

Out-of-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital per Stay $0 or $1960
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.
Prior authorization required
Mental Health Outpatient Care
In Network
In-Network:
Copayment for Medicare-covered Individual Sessions $0
Copayment for Medicare-covered Group Sessions $0


Out of Network

Out-of-Network:

Medicare Covered Mental Health Services:
Coinsurance for Medicare Covered Individual Sessions 0% or 20%
Coinsurance for Medicare Covered Group Sessions 0% or 20%
Outpatient Services / Surgery
In Network
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0
Prior Authorization Required for Outpatient Hospital Services
Note: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Note: 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.


Out of Network

Out-of-Network:

Medicare Covered Outpatient Hospital Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 0% or 20%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 0% or 20%
Note: $0 copayment for outpatient diagnostic colonoscopies. The higher cost share applies to all other outpatient procedures.Note: Benefit category includes both the facility and professional component.
Prior authorization required
Outpatient Substance Abuse Care
In Network
In-Network:
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.


Out of Network

Out-of-Network:

Medicare Covered Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 0% or 20%
Coinsurance for Medicare Covered Group Sessions 0% or 20%
Note: $0 copayment applies to Medicare covered telehealth for individual sessions. The higher cost share applies to all other Medicare covered services.
Prior authorization required
Over-the-counter (OTC) Items
In Network
In-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0
Note: Plan offers a monthly benefit credit that can be used to either purchase items from a catalog and/or a retail card allowing members to receive Over The Counter healthcare items.


Out of Network

Out-of-Network:

Non-Medicare Covered Over-The-Counter (OTC) Items Services:
Copayment for Non-Medicare Covered Over-The-Counter (OTC) Items $0
Podiatry Services
In Network
In-Network:

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


Out of Network

Out-of-Network:

Medicare Covered Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 0% or 20%

Non-Medicare Covered Podiatry Services:
Copayment for Non-Medicare Covered Podiatry Services $0
Prior authorization required
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
Prior authorization required

Dental Benefits

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

Coverage Cost
Dental Care
In Network
In-Network:

Preventive Dental:
Copayment for Office Visit $0
Prior Authorization Required for Preventive Dental


Out of Network

Out-of-Network:

Medicare Covered Preventive Dental Services:
Coinsurance for Medicare Covered Preventive Dental 0% or 20%
Prior authorization required

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:
Plan pays up to $100 every year for 1 pair of frames or contact lenses. Standard single, bifocal, trifocal, or progressive lenses are covered in full.
Home-delivered eyewear available nationwide only through UnitedHealthcare Vision (select products only).

Hearing Benefits

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

Coverage Cost
Hearing Benefits
In Network
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $0
Copayment for Routine Hearing Exams $0
  • Maximum 1 visit every year
Prior Authorization Required for Hearing Exams

Hearing Aids:
Copayment for Hearing Aids $0
  • Maximum 2 Hearing Aids every year
Maximum Plan Benefit of $1,500 every year


Out of Network

Out-of-Network:

Medicare Covered Hearing Exams Services:
Coinsurance for Medicare Covered Hearing Exams 0% or 20%
Prior authorization required

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
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



    Out of Network

    Out-of-Network:

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