UHC Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams. Members must have Medicaid to enroll.
Health Maintenance Organization (HMO) plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care.
Point of Service (HMO-POS) plans include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost. Some POS plans only cover out-of-network dental care. In addition, some POS plans do not require referrals for specialty care.
Preferred Provider Organization (PPO) plans work with a network of contracted local physicians and hospitals, but also allows members the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Members do not need a referral for specialty care.
PPO plans are available as either local PPO (certain counties within a state) or regional PPO (RPPO) offerings. RPPOs serve a larger geographic area - either a single state or a multi-state area. RPPOs offer the same premiums, benefits and cost-sharing requirements to all members in the region.
UnitedHealthcare Medicare Advantage Special Needs Plans (SNPs) combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional features and benefits designed to meet the unique needs of identified Medicare consumer populations.
Quick Reference and Overview
2024 Plan Resource Materials
Quick Reference Guides
- 2024 UHC Dual Complete TX Quick Reference Guide: H2406-050-000, H4514-013-001, H4514-013-002, H4514-013-003, H4514-019-000, H4514-021-000
- 2024 UHC Dual Complete TX Quick Reference Guide: H5322-025-000, H5322-038-000
- 2024 UHC Dual Complete TX Quick Reference Guide: R6801-011-000
- 2024 UHC Dual Complete TX Quick Reference Guide: H0609-052-000, H0609-053-000, H0609-057-000,H0609-064-000, H0609-065-000, H4514-016-000, H4514-018-000, H4527-003-000, H4527-004-000, H4527-006-000, H4527-015-000, H5322-026-000
Frequently Asked Questions
- 2024 UHC Dual Complete TX-D004 Frequently Asked Questions H0609-052-000
- 2024 UHC Dual Complete TX-D005 Frequently Asked Questions H0609-053-000
- 2024 UHC Dual Complete TX-D006 Frequently Asked Questions H0609-057-000
- 2024 UHC Dual Complete TX-V006 Frequently Asked Questions H0609-064-000
- 2024 UHC Dual Complete TX-V007 Frequently Asked Questions H0609-065-000
- 2024 UHC Dual Complete TX-D001 Frequently Asked Questions H2406-050-000
- 2024 UHC Dual Complete TX-D002 Frequently Asked Questions H4514-013-001
- 2024 UHC Dual Complete TX-D002 Frequently Asked Questions H4514-013-002
- 2024 UHC Dual Complete TX-D002 Frequently Asked Questions H4514-013-003
- 2024 UHC Dual Complete TX-D01P Frequently Asked Questions H4514-016-000
- 2024 UHC Dual Complete TX-V01P Frequently Asked Questions H4514-018-000
- 2024 UHC Dual Complete TX-S003 Frequently Asked Questions H4514-021-000
- 2024 UHC Dual Complete TX-V002 Frequently Asked Questions H4527-003-000
- 2024 UHC Dual Complete TX-V003 Frequently Asked Questions H4527-004-000
- 2024 UHC Dual Complete TX-V004 Frequently Asked Questions H4527-006-000
- 2024 UHC Dual Complete TX-D003 Frequently Asked Questions H4527-015-000
- 2024 UHC Dual Complete TX-D007 Frequently Asked Questions H5322-025-000
- 2024 UHC Dual Complete TX-V005 Frequently Asked Questions H5322-026-000
- 2024 UHC Dual Complete TX-V010 Frequently Asked Questions H5322-038-000
- 2024 UHC Dual Complete TX-S001 Frequently Asked Questions R6801-011-000
Formulary Lookup
- 2024 UnitedHealthcare Connected® (Medicare-Medicaid Plan) Pharmacy Formulary (PDF)
- 2024 UnitedHealthcare Connected (Medicare-Medicaid Plan) Pharmacy Formulary Lookup Tool
- 2024 UnitedHealthcare Dual Complete® Pharmacy Formulary Lookup Tool
Additional State-Specific Claims Resources
- 2024 Medicare Advantage - Quick Reference Guide - TX WELM2
2024 Key Resources
- 2024 Medicare Advantage and DSNP Quick Reference Guide
- 2024 Medicare Advantage and DSNP Plan Overview Course
Tools and Resources - UnitedHealthcare Dual Complete Plans
- Medicare Advantage Benefit Plan Names
- Inflation Reduction Act - Frequently Asked Questions
- Medicare Advantage Chiropractic and Acupuncture Coverage – Quick Reference Guide
- Medicare Advantage Copayment Guidelines
- Medicare Advantage Home Health Services Frequently Asked Questions
- Medicare Advantage Member Rights and Responsibilities
- Medicare Advantage Non-Contracted Provider Dispute and Appeal Rights
- Medicare Advantage Preventive Screening Guidelines
- Readmission Review Program Clinical Guidelines
- Readmission Review Program Frequently Asked Questions
Guides, Policies, Provider Directory, and Training
- UnitedHealthcare Administrative Guide
- UnitedHealthcare Medicare Advantage Coverage Summaries
- UnitedHealthcare Medicare Advantage Reimbursem*nt Policies
- Additional Medicare Advantage Policies
- UnitedHealthcare Medicare Prior Authorization Requirements
- Medicare Advantage Drug Formulary - UHC.com/medicare (enter zipcode and select plan)
- 2024 UnitedHealthcare Dual Complete Formulary Lookup Tool
- Medicare Advantage Care Provider Search
- Training and Presentations
Additional Medicare Advantage Plan Information
To learn more about the Medicare Advantage plans offered in your area, visitUHC.com/medicareand enter your ZIP code.
Medicare Part D Information
To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on thePlan Information and Formspage of UHC.com/medicare.
