2027 UHC Dual Complete NY-YL (HMO-POS D-SNP)
Medicare
What is a dual special needs plan?
H3387-013 -000
Monthly premium: $0.00 *
* Your costs may be as low as $0, depending on your level of Medicaid eligibility.
Our plan is a Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization) with a Point-of-Service (POS) option approved by Medicare and run by a private company. "Point-of-Service" means you can use providers outside the plan's network for an additional cost. For those who have full Medicaid benefits. Must have full Medicaid benefits and meet Medicaid Advantage Plus (MAP) eligibility for long-term services or nursing home-level care. When enrolling, you must also apply for the UHC MAP plan: NY: FBDE, QMB PLUS. Integrated SEP available. View your state-level D-SNP Enrollment At-a-Glance guide on Jarvis to learn more. Special eligibility requirement
Our plan is a plan for individuals who have Medicare and Medicaid coverage and need long term care. Enrollment in the program includes coverage for all Medicare and Medicaid services.
This plan is available in the following counties:
Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Queens, Rensselaer, Richmond, Rockland, Schenectady, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, Westchester, Wyoming, and Yates.
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Check eligibility
Special eligibility requirements
If you can answer "yes" to the three questions below, there's a good chance you may qualify for this dual health plan.
- You’re at least 65 years old, or you’re under 65 and qualify on the basis of disability or other special situation.
AND- You’re a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years.
Are you 65 years or older but don’t qualify?
- 2027 UHC Dual Complete NY-YL (HMO-POS D-SNP)
1-844-812-5967 TTY: 711 8 a.m.-8 p.m. local time, 7 days a week
Find providers and coverage for this plan.
Search for doctors, hospitals, and specialists.
Search for providers, clinics and treatment centers.
Find medications covered by this plan.
Find a pharmacy near you.
Find a dentist near you.
Find a vision provider near you.
Benefits & features
$425 credit every month for OTC, plus healthy food and utilities for qualifying members
Unlimited dental allowance for covered preventive and comprehensive services
$0 copay on hundreds of covered generic prescriptions
Dedicated care support to help access, plan and coordinate care and resources
60 one-way trips for doctor and pharmacy visits
Fitness benefit
Free gym membership at core locations
Medical visits
$0 copay for hospital stays, PCP and specialist visits
Provider network
Large network of providers
Optum HouseCalls
Yearly in-home health and wellness visit with a licensed health care practitioner
Benefits, features and/or devices may vary by plan/area.
Limitations, exclusions and/or network restrictions may apply.
You could pay $0 for Tier 1 and/or Tier 2 Part D-covered prescriptions across all payment stages when filling at a network pharmacy.
Review your plan Drug List (Formulary) on UHC.com/Medicare for a list of covered prescription drugs, including those on Tier 1 and Tier 2.
Optum HouseCalls may not be available in all areas.
The fitness benefits and gym networks vary by plan/area and participating locations may change. The fitness benefit includes a standard fitness membership at participating locations. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine.
Routine transportation not for use in emergencies.
A trip is one-way and roundtrip is two trips.
Review your Evidence of Coverage (EOC) for more information.
If your plan offers out-of-network dental coverage and you see an out-of-network dentist, you might be billed more. Network size varies by local market.
Some covered dental services may require a prior authorization.
Network size varies by local market and exclusions may apply.
Referrals may be needed to see network specialists.
OTC, food and utility benefits have expiration timeframes.
The healthy food and utilities benefit is a special supplemental benefit available only to chronically ill enrollees with a qualifying condition, such as diabetes, cardiovascular disorders, chronic heart failure, chronic high blood pressure and/or chronic high cholesterol, who also meet plan criteria indicating they are at high risk for hospitalization and eligible for intensive care coordination.
There may be other qualifying chronic conditions not listed. If you use this benefit for certain utilities, it may be considered income for housing assistance. Check with your housing authority for details.
UHC Dual Complete NY-YL (HMO-POS D-SNP)
Monthly plan premium for people who get Extra Help from Medicare to help pay for their prescription drug costs
If you get Extra Help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get Extra Help from Medicare. The amount of Extra Help you get will determine your total monthly plan premium as a member of our Plan.
This table shows you what your monthly plan premium will be if you get Extra Help.
| Your level of Extra Help | Monthly premium* |
|---|---|
| 100% | $0.00 |
*This does not include any Medicare Part B premium you may have to pay.
If you aren’t getting Extra Help, you can see if you qualify by calling:
- 1-800-Medicare or TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
- Your State Medicaid Office, or
- The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 8 a.m. and 7 p.m., Monday through Friday.
Your health care needs are unique. These documents can help you make sure you get the right coverage.
Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary of Benefits, Other downloadable resources.
Learn more about dual special needs plans
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UHC Dual Complete NY-YL (HMO-POS D-SNP)