UHC PathWays Dual Care IN-YL (PPO D-SNP)
Available to residents of Posey County, IN for 2027. Contract H2385, plan 004, segment 0.
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- Benefits in plain text
- Other plans in Posey County
- Plan website
- Browse the UHC PathWays Dual Care IN-YL (PPO D-SNP) formulary
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Consolidated into another plan for 2027. CMS crosswalks 2026’s UHC Dual Complete IN-S002 (PPO D-SNP) (H2385-001-0) into this plan, so its members move here unless they choose otherwise. Every IN plan’s 2026–2027 changes →
Plan details
| Monthly premium (Part C + D) | $17.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $17.00? |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| In-network out-of-pocket maximum | $9,850.00? |
| In- and out-of-network out-of-pocket maximum | $14,800.00 |
| Drug deductible | $700.00 |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | PPO D-SNP? |
| Special needs plan | Dual-eligible SNP |
| D-SNP integration status | Fully Integrated (FIDE) |
| Zero-dollar cost sharing D-SNP | Yes |
| Contract / plan | H2385-004-0 |
| Offered by | UnitedHealthcare |
| Parent organization | UnitedHealth Group, Inc. |
| Pharmacy search | UHC.com/CommunityPlan |
| Member services | (888)834-3721TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H2385 shares this rating.
Plan health benefits
| Service | In-network | Out-of-network? |
|---|---|---|
| Doctor visits | ||
| Primary care doctor | $0 copay | 30% coinsurance |
| Specialist | $0 copay(authorization required) | 30% coinsurance |
| Other health care professional | $0 copay(authorization required) | 30% coinsurance |
| Additional telehealth services | Not covered | — |
| Preventive care | ||
| Medicare-covered preventive services | $0 copay | 0%–40% coinsurance |
| Annual physical exam | $0 copay | 40% coinsurance |
| Kidney disease education | $0 copay | 40% coinsurance |
| Glaucoma screening | $0 copay | 40% coinsurance |
| Diabetes self-management training | $0 copay | 40% coinsurance |
| Diagnostic tests, labs and imaging | ||
| Diagnostic tests and procedures | $0 copay(authorization required) | 40% coinsurance |
| Lab services | $0 copay(authorization required) | $0 copay |
| Diagnostic radiology (e.g. MRI, CT) | $0 copay(authorization required) | 40% coinsurance |
| Therapeutic radiology | 20% coinsurance(authorization required) | 20% coinsurance |
| Outpatient x-rays | $0 copay(authorization required) | 40% coinsurance |
| Emergency and urgent care | ||
| Emergency room | $115 copay | — |
| Urgent care | $0–$40 copay | — |
| Worldwide emergency coverage | Not covered | — |
| Worldwide urgent care | Not covered | — |
| Worldwide emergency transportation | Not covered | — |
| Hospital care | ||
| Inpatient hospital stay | $0 per day for days 91–999 (additional days)(authorization required) | — |
| Outpatient hospital services | 0%–20% coinsurance(authorization required) | 40% coinsurance |
| Outpatient observation | 20% coinsurance(authorization required) | 40% coinsurance |
| Ambulatory surgical center | 0%–20% coinsurance(authorization required) | 40% coinsurance |
| Outpatient blood services | 20% coinsurance(authorization required) | 40% coinsurance |
| Skilled nursing and home health | ||
| Skilled nursing facility | Original Medicare cost-sharing(authorization required) | Original Medicare cost-sharing |
| Home health care | $0 copay(authorization required) | $0 copay |
| Kidney dialysis | 20% coinsurance(authorization required) | 20% coinsurance |
| Rehabilitation | ||
| Occupational therapy | $0 copay(authorization required) | 30% coinsurance |
| Physical therapy and speech-language therapy | $0 copay(authorization required) | 30% coinsurance |
| Cardiac rehabilitation | 20% coinsurance(authorization required) | 30% coinsurance |
| Pulmonary rehabilitation | $0 copay(authorization required) | 30% coinsurance |
| Mental health and substance use | ||
| Inpatient psychiatric hospital stay | $0 per stay(authorization required) | — |
| Outpatient mental health, individual session | 0%–20% coinsurance(authorization required) | 30% coinsurance |
| Outpatient mental health, group session | 20% coinsurance(authorization required) | 30% coinsurance |
| Psychiatrist, individual session | 0%–20% coinsurance(authorization required) | 30% coinsurance |
| Psychiatrist, group session | 20% coinsurance(authorization required) | 30% coinsurance |
| Partial hospitalization | $55 copay(authorization required) | 30% coinsurance |
| Intensive outpatient program | $55 copay(authorization required) | 30% coinsurance |
| Outpatient substance use, individual session | 0%–20% coinsurance(authorization required) | 30% coinsurance |
| Outpatient substance use, group session | 20% coinsurance(authorization required) | 30% coinsurance |
| Opioid treatment program | $0 copay(authorization required) | $0 copay |
| Ambulance and transportation | ||
| Ground ambulance | 20% coinsurance(authorization required) | 20% coinsurance |
| Air ambulance | 20% coinsurance(authorization required) | 20% coinsurance |
| Transportation to plan-approved locations | $0 copay(limits apply) | 75% coinsurance |
| Medical equipment and supplies | ||
| Durable medical equipment (e.g. wheelchairs, oxygen) | 20% coinsurance(authorization required) | 20% coinsurance |
| Prosthetics (e.g. braces, artificial limbs) | 20% coinsurance(authorization required) | 20% coinsurance |
| Medical supplies | 20% coinsurance(authorization required) | 20% coinsurance |
| Diabetes supplies | $0 copay(authorization required) | 20% coinsurance |
| Diabetic therapeutic shoes or inserts | 20% coinsurance(authorization required) | 20% coinsurance |
| Chiropractic, acupuncture and foot care | ||
| Chiropractic (Medicare-covered) | 20% coinsurance(authorization required) | 30% coinsurance |
| Routine chiropractic care | Not covered | — |
| Acupuncture | Not covered | — |
| Foot exams and treatment (Medicare-covered) | 20% coinsurance(authorization required) | 30% coinsurance |
| Routine foot care | $0 copay(authorization required, limits apply) | 30% coinsurance |
| Dental? | ||
| Medicare-covered dental services | 20% coinsurance(authorization required) | 40% coinsurance |
| Preventive dental plan limit | $5,000 plan limit every year | — |
| Oral exams | $0 copay(limits apply) | $0 copay |
| Cleanings | $0 copay(limits apply) | $0 copay |
| Fluoride treatment | $0 copay(limits apply) | $0 copay |
| Dental x-rays | $0 copay(limits apply) | $0 copay |
| Other diagnostic dental services | $0 copay(limits apply) | $0 copay |
| Other preventive dental services | $0 copay(limits apply) | $0 copay |
| Restorative services (fillings, crowns) | $0 copay(limits apply) | $0 copay |
| Endodontics (root canals) | $0 copay(limits apply) | $0 copay |
| Periodontics (gum disease) | $0 copay(limits apply) | $0 copay |
| Dentures and other removable prosthodontics | $0 copay(limits apply) | $0 copay |
| Maxillofacial prosthetics | $0 copay(limits apply) | $0 copay |
| Implants | Not covered | — |
| Bridges and other fixed prosthodontics | $0 copay(limits apply) | $0 copay |
| Oral and maxillofacial surgery | $0 copay(limits apply) | $0 copay |
| Orthodontics | Not covered | — |
| Adjunctive general services | $0 copay(limits apply) | $0 copay |
| Vision? | ||
| Eye exam (Medicare-covered) | $0 copay(authorization required) | 30% coinsurance |
| Routine eye exam | $0 copay(authorization required, limits apply) | 30% coinsurance |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(limits apply) | 40% coinsurance |
| Eyewear plan limit | $500 plan limit every year | — |
| Contact lenses | $0 copay(limits apply) | 90% coinsurance |
| Eyeglasses (frames and lenses) | $0 copay(limits apply) | 90% coinsurance |
| Eyeglass lenses | Not covered | — |
| Eyeglass frames | Not covered | — |
| Eyewear upgrades | Not covered | — |
| Hearing? | ||
| Hearing exam (Medicare-covered) | 20% coinsurance(authorization required) | 30% coinsurance |
| Routine hearing exam | $0 copay(authorization required, limits apply) | 30% coinsurance |
| Hearing aid fitting and evaluation | Not covered | — |
| Hearing aid plan limit | $3,200 plan limit every two years | — |
| Hearing aids (all types) | $0 copay(authorization required, limits apply) | 90% coinsurance |
| Hearing aids, inner ear | Not covered | — |
| Hearing aids, outer ear | Not covered | — |
| Hearing aids, over the ear | Not covered | — |
| Medicare Part B drugs | ||
| Part B insulin | 0%–20% coinsurance(authorization required) | 20% coinsurance |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required) | 20% coinsurance |
| Other Part B drugs | 0%–20% coinsurance(authorization required) | 20% coinsurance |
| Other extra benefits? | ||
| Over-the-counter (OTC) allowance | Covered (allowance not stated) | — |
| Meals after a hospital stay or for a chronic condition | Not covered | — |
| Fitness benefit | $0 copay | 90% coinsurance |
| Health education | Not covered | — |
| Nutritional / dietary benefit | Not covered | — |
| Extra smoking and tobacco cessation counseling | Not covered | — |
| Enhanced disease management | Not covered | — |
| Telemonitoring | Not covered | — |
| Remote access technologies (web/phone, nurse line) | Not covered | — |
| Home and bathroom safety devices | $0 copay | 90% coinsurance |
| Counseling services | Not covered | — |
| In-home safety assessment | Not covered | — |
| Personal emergency response system (PERS) | Not covered | — |
| Medical nutrition therapy | Not covered | — |
| Post-discharge in-home medication reconciliation | Not covered | — |
| Re-admission prevention | Not covered | — |
| Wigs for hair loss from chemotherapy | Not covered | — |
| Weight management programs | $0 copay | 90% coinsurance |
| Alternative therapies | Not covered | — |
| Therapeutic massage | Not covered | — |
| Adult day health services | Not covered | — |
| Home-based palliative care | Not covered | — |
| In-home support services | $0 copay | 90% coinsurance |
| Support for caregivers | $0 copay | 90% coinsurance |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2027). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed; an out-of-network dash means the plan files no separate out-of-network cost for that service. Contact the plan for the full Evidence of Coverage.
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Health Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | too new |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | too new |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H2385 shares it.
Also available in 91 other IN counties
- Adams
- Allen
- Bartholomew
- Benton
- Blackford
- Boone
- Brown
- Carroll
- Cass
- Clark
- Clay
- Clinton
- Crawford
- Daviess
- Dearborn
- Decatur
- DeKalb
- Delaware
- Dubois
- Elkhart
- Fayette
- Floyd
- Fountain
- Franklin
- Fulton
- Gibson
- Grant
- Greene
- Hamilton
- Hancock
- Harrison
- Hendricks
- Henry
- Howard
- Huntington
- Jackson
- Jasper
- Jay
- Jefferson
- Jennings
- Johnson
- Knox
- Kosciusko
- Lagrange
- Lake
- La Porte
- Lawrence
- Madison
- Marion
- Marshall
- Martin
- Miami
- Monroe
- Montgomery
- Morgan
- Newton
- Noble
- Ohio
- Orange
- Owen
Benefits in plain text
UHC PathWays Dual Care IN-YL (PPO D-SNP) (H2385-004-0) is a 2027 PPO D-SNP Medicare Advantage plan offered by UnitedHealthcare, available to residents of Posey County, IN.
The monthly premium is $17.00.
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
Its in-network out-of-pocket maximum is $9,850.00.
The combined in- and out-of-network out-of-pocket maximum is $14,800.00.
The drug deductible is $700.00.
It is a special needs plan (Dual-eligible SNP).
Email a copy of the plan benefit details
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.