UHC PathWays Dual Care IN-YL (PPO D-SNP)

UNITEDHEALTHCARE INSURANCE COMPANY · 2027 plan year

Plan ID H2385-004-000

Local PPODual-Eligible SNP
MOOP (in-network)
$9,850
MOOP (combined)
$14,800
Monthly premium
$17/mo
Part C $0 + Part D $17, before Extra Help
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H2385-004-000
Medical deductible
$0 — no deductible
Part D premium
$17/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More UNITEDHEALTHCARE INSURANCE COMPANY plans in IN

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — AcuteNo charge
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — PsychiatricNo charge

Pharmacy

BenefitIn-network
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance
Part B DrugsSee plan details

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions0%-20% coinsurance
Mental Health — Group Sessions20% coinsurance
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Diabetic Supplies & ServicesSee plan details
Occupational Therapy ServicesNo charge
Urgently Needed Services$0-$40
Physician Specialist ServicesNo charge
Podiatry Services20% coinsurance
Radiological ServicesSee plan details
Therapeutic Radiology20% coinsurance
X-Ray ServicesNo charge
Outpatient Hospital Services0%-20% coinsurance
Hospital Observation Services20% coinsurance
Ambulatory Surgical Center (ASC)0%-20% coinsurance
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions0%-20% coinsurance
Outpatient Blood Services20% coinsurance
Air Ambulance20% coinsurance
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic MonitorsNo charge
Dental — Removable Prosthodontics (Dentures)No charge
Vision — Eye ExamsSee plan details
Vision — Contact LensesNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Periodontics (Gum Care)No charge
Diagnostic Procedures & TestsNo charge
Emergency Services$115
Diagnostic Tests & Lab ServicesSee plan details
Psychiatric ServicesSee plan details
Primary Care Physician ServicesNo charge
Chiropractic Services20% coinsurance
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Laboratory ServicesNo charge
Diagnostic RadiologyNo charge
Substance Abuse — Group Sessions20% coinsurance
Ambulance ServicesSee plan details
Ground Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Medical Supplies20% coinsurance
Dialysis Services20% coinsurance
Dental — Maxillofacial ProstheticsNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye ExamsNo charge
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Eyeglasses (Lenses & Frames)No charge
Hearing — Exams20% coinsurance
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Weight Management ProgramNo charge
In-Home Support ServicesNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services20% coinsurance
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Skilled Nursing Facility (SNF)Original Medicare cost sharing
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions20% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions20% coinsurance
Pulmonary Rehabilitation — Additional SessionsNo charge
Supervised Exercise Therapy (SET)No charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric Services — Individual Sessions0%-20% coinsurance
Psychiatric Services — Group Sessions20% coinsurance
Physical Therapy & Speech-Language PathologyNo charge
Opioid Treatment Program ServicesNo charge
Over-the-Counter (OTC) ItemsNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Home & Bathroom Safety DevicesNo charge
Caregiver Support ServicesNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal Exams20% coinsurance
Welcome to Medicare EKG20% coinsurance
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge

Service area

  • IN: 92 counties

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