UnitedHealthcare Dual Complete Plans

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UnitedHealthcare sells a range of Medicare insurance plans, and among them are a type of plan called UnitedHealthcare Dual Complete. Depending on where you live and your eligibility, you may be able to find and enroll in a UHC Dual Complete plan if it’s the right fit for you.

What Are UnitedHealthcare Dual Complete Plans?

UnitedHealthcare Dual Complete plans are Special Needs Plan, also called D-SNPs. Plans like these provide coverage and benefits for people with Medicaid and Medicare. However, SNP plans require members to be enrolled in Medicaid to gain benefits like routine vision exams, medical appointments, and even transportation.

A Special Needs Plan (SNP) is a type of Medicare Advantage (Medicare Part C) plan that is designed for beneficiaries with specific health conditions, living situations or financial circumstances.

Is UHC Dual Complete Both Medicare and Medicaid?

UHC Dual Complete includes both Medicare and Medicaid benefits. 

UHC Dual Complete plans cover everything found in Original Medicare (Medicare Part A and Part B). That includes both inpatient and outpatient care and durable medical equipment (DME). 

As a Medicare Advantage plan, UHC Dual Complete plans can also cover benefits that Original Medicare doesn’t cover, such as hearing, vision, dental and prescription drug coverage covered by Medicare Part D. 

UHC Dual Complete plans also cover Medicaid benefits, and they coordinate with state Medicaid programs that offer overlapping benefits. In these cases, Medicare is the primary payer and then Medicaid pays second.

Medicaid coverage varies by state, and most Medicaid benefits are covered by Medicare, so the real benefit to these plans as it relates to Medicaid is that most or all of you out-of-pocket Medicare costs (deductibles, copays, coinsurance, etc.) can be covered by the plan. 

What Are the Benefits of UnitedHealthcare Dual Complete?

In addition to including all of the same benefits as Original Medicare, UHC Dual Complete providers also include a number of benefits not found in Medicare Part A or Part B such as coverage for dental, vision, hearing, prescription drugs, transportation and even things like acupuncture, chiropractic care, over-the-counter health products and gym memberships. 

What Are the Eligibility Requirements for UHC Dual Complete?

First, you must be eligible for Medicare. That requires being at least 65 years old or having a qualifying disability along with being a U.S. citizen or permanent legal resident. 

Next, you must be eligible for Medicaid. Medicaid eligibility varies by state, contains different categories and is based largely on income and assets. Some states also have age restrictions for Medicaid eligibility.

UHC Dual Complete is also available to beneficiaries of each of the four following programs:

1. Qualified Medicare Beneficiary Plus (QMB+)
2. Qualified Medicare Beneficiary (QMB)
3. Specified Low-Income Medicare Beneficiary (SLMB+)
4. Full Benefits Dual Eligible (FBDE)

How Do You Enroll in UnitedHealthcare Dual Complete?

You may enroll in a UnitedHealthcare Dual Complete plan when you first become eligible for Medicare during your Initial Enrollment Period. 

You may also enroll during the Medicare Annual Enrollment Period that takes place every year from Oct. 15 to Dec. 7. This is also called the fall Medicare Open Enrollment Period.

If you move to a new area or experience another qualifying life event, you may be granted a Special Enrollment Period during which you may be able to enroll in a UnitedHealthcare Dual Complete plan. 

You may only enroll in a Medicare Advantage plan that is sold in the area in which you live. There are numerous insurance carriers that sell Special Needs Plans and other types of Medicare Advantage plans, so it’s a good idea to work with a licensed insurance agent to ensure you review all of your available options and choose the plan that is the best fit for your needs.