UHC Dual Complete KY-V001 (HMO-POS D-SNP) H6595-003 • 2026 • Trigg County, KY
CMS Plan ID H6595-003 identifies the Medicare Dual-Eligible plan UHC Dual Complete KY-V001, offered by UnitedHealthcare for the 2026 plan year. This Special Needs Plan (SNP) is designed for individuals who meet specific eligibility requirements.
UHC Dual Complete KY-V001 Overview
Plan Overview for
H6595-003-0
|
|
|---|---|
| CMS Plan ID: |
H6595-003-0
|
| Plan Type: | HMO-POS D-SNP |
| Plan Year: | 2026 |
| Monthly Premium: |
$38.40
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $6700.00 (In-Network) |
| Part B Give Back: | −$0.50 reduction |
| Prescription Drug Coverage: | Enhanced, $615.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Trigg County, KY |
| Enrollment (Nationwide): | 4,429 beneficiaries |
| Enrollment (CMS – Local) | 18 beneficiaries in Trigg County |
| Provided By: | UnitedHealthcare |
Plan Overview and Eligibility
UHC Dual Complete KY-V001 is a Medicare D-SNP plan for people who qualify for both Medicare and Medicaid.
| Special Needs Plan Type: | Dual-Eligible Special Needs Plan (D-SNP) |
|---|---|
| Medicare Requirement: | Medicare Part A and Part B |
| Special Needs Requirement: | Must qualify for Medicaid |
| Service Area Requirement: | Must live in the plan's service area |
| Prescription Drug Coverage: | Medicare Part D prescription drug coverage is included. |
UHC Dual Complete KY-V001 operates on a Health Maintenance Organization Point-of-Service (HMO-POS) network. Members usually access care through in-network providers, with referrals often needed for specialty services. Limited out-of-network care may be available, typically at higher out-of-pocket costs. Emergency services and out-of-area dialysis are covered.
Covered Services & Costs
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay |
| Specialist: | In-network: $0 or $0-$30 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0 or $0-$190 copay |
| Lab services: | In-network: $0 copay |
| Outpatient x-rays: | In-network: $0 or $25 copay |
| Diagnostic tests and procedures: | In-network: $0 or $40 copay |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $0 or $130 copay |
| Worldwide emergency care: | $0 copay |
| Urgent care: | $0 or $0-$50 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $0 or $455 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $0 or $218 per day for days 21-100 |
| Ground ambulance: | In-network: $0 or $290 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $0 or $0-$25 copay |
| Outpatient group therapy: | In-network: $0 or $15 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $0 or $455 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $0 or $25 copay |
| Occupational therapy: | In-network: $0 or $25 copay |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay |
| Durable medical equipment: | In-network: 0% or 20% coinsurance |
| Prosthetics: | In-network: 0% or 20% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0% or 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0% or 0%-20% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay |
| Periodontics: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Endodontics: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Restorative services: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: 50% coinsurance | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay |
| Contact lenses: | In-network: $0 copay |
| Eyeglass frames only: | In-network: $0 copay |
| Eyeglass lenses only: | In-network: $0 copay |
| Eyeglasses (frames & lenses): | Not covered |
| Upgrades: | Not covered |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay |
| Fitting/evaluation: | Not covered |
| Prescription hearing aids: | In-network: $199-$1249 copay |
| OTC hearing aids: | In-network: $199-$829 copay |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | In-network: $0 copay |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: $0 copay |
Certain preventive services are covered 100% by UHC Dual Complete KY-V001 as a Part B benefit.
Prescription Drug Coverage
UHC Dual Complete KY-V001 includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Special Needs Plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Basic Part D Premium: | $38.40 |
|---|---|
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $38.40 |
| Low-Income Premium Subsidy: | $38.44 |
| Low-Income Premium Subsidy Paid by CMS: | $38.40 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before UnitedHealthcare starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, UHC Dual Complete KY-V001 may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | 25% coinsurance | Coming soon |
| Preferred Brand | 25% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 25% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS Star Ratings
CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for UnitedHealthcare
| Contact Type | Details |
|---|---|
| Website: | UnitedHealthcare Plan Page |
| New Members: | 1-888-834-3721 |
| Existing Members: | 1-844-855-9774 |
| Plan Address: | P.O. Box 30770 | Salt Lake City, UT 84130 |
Enrollment status and eligibility information are available through the Social Security Administration . Additional information about Medicare Advantage is available at medicare.gov .
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| UnitedHealthcare (official source) | http://UHC.com/CommunityPlan | October 13, 2025 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | April 28, 2026 |
| Medicare.gov | Joining a plan | April 28, 2026 |
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