UHC Dual Complete MS-S3 (PPO D-SNP)

CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. · 2027 plan year

Plan ID H1889-044-002

Local PPO★ 3.5 CMS StarsDual-Eligible SNP
MOOP (in-network)
$9,850
MOOP (combined)
$14,800
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H1889-044-002
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$455/yr
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

More CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. plans in MS

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Psychiatric$1,480 per stay
Inpatient Hospital — Acute$1,480 per stay
Inpatient Hospital — Additional Days (Acute)No 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 — Individual Sessions0%-20% coinsurance
Mental Health — Group Sessions20% coinsurance
Supplemental Health BenefitsSee plan details
Mental Health Specialty ServicesSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)Original Medicare cost sharing
Cardiac Rehabilitation — Additional Sessions20% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions20% coinsurance
Pulmonary Rehabilitation — Additional Sessions20% coinsurance
Supervised Exercise Therapy (SET)20% coinsurance
Emergency Services$115
Urgently Needed Services$0-$40
Partial Hospitalization Program$55
Intensive Outpatient Program (IOP)$55
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist ServicesNo charge
Podiatry ServicesNo charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions0%-20% coinsurance
Psychiatric Services — Group Sessions20% coinsurance
X-Ray Services20% coinsurance
Physical Therapy & Speech-Language PathologyNo charge
Opioid Treatment Program ServicesNo charge
Diagnostic Procedures & Tests20% coinsurance
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology0%-20% coinsurance
Therapeutic Radiology20% coinsurance
Outpatient Hospital ServicesNo charge
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)No charge
Substance Abuse — Individual Sessions0%-20% coinsurance
Substance Abuse — Group Sessions20% coinsurance
Outpatient Blood Services20% coinsurance
Ambulance ServicesSee plan details
Ground Ambulance20% coinsurance
Air Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Home & Bathroom Safety DevicesNo charge
Weight Management ProgramNo charge
In-Home Support ServicesNo 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
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services20% coinsurance
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Vision — Eye ExamsNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Maxillofacial ProstheticsNo charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Hearing — Exams20% coinsurance
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Cardiac & Pulmonary RehabilitationSee plan details
Diagnostic Tests & Lab ServicesSee plan details
Outpatient Substance Abuse ServicesSee plan details
Prosthetics & OrthoticsSee plan details
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge

Service area

  • MS: 29 counties

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