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North Carolina UnitedHealthcare Dual Complete® Special Needs Plans

UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, including transportation to medical appointments and vision exams. Members must have Medicaid to enroll.

  • UnitedHealthcare Dual Complete® (HMO SNP)
  • UnitedHealthcare Dual Complete® RP (Regional PPO SNP)

Health Maintenance Organization (HMO) plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care.

About RPPO-SNP Plans

Preferred Provider Organization (PPO) plans work with a network of contracted local physicians and hospitals, but also allows members the flexibility to seek covered services from outside of the contracted network, usually at a higher cost. Members do not need a referral for specialty care.

PPO plans are available as either local PPO (certain counties within a state) or regional PPO (RPPO) offerings. RPPOs serve a larger geographic area - either a single state or a multi-state area. RPPOs offer the same premiums, benefits and cost-sharing requirements to all members in the region.

UnitedHealthcare Medicare Advantage Special Needs Plans (SNPs) combine the hospital and doctor coverage of Medicare Parts A and B with Part D prescription drug coverage, plus additional features and benefits designed to meet the unique needs of identified Medicare consumer populations.

Dual Complete Regional (RPPO-SNP) Program

Effective January 1, 2018, UnitedHealthcare Community Plan of North Carolina launches a new Dual Special Needs Plan (DSNP) – UnitedHealthcare Dual Complete (RPPO-SNP), a State wide Medicare Advantage program.

The Dual Complete RP SNP program is a Medicare Advantage plan for members who qualify for both Medicare and Medicaid. DSNPs are a specialized type of Medicare Advantage Prescription Drug Plan (MAPD) and must follow existing Centers for Medicare & Medicaid Services (CMS) rules. DSNPs must:

  • Adhere to required MAPD benefits
  • Limit enrollment to Medicaid recipients (dually eligible – Medicare and Medicaid),
  • Provide Part D benefits, and
  • Offer targeted clinical programs, benefits, and services.

RPPO-SNP Program Resources

Learn More

UnitedHealthcare Dual Complete (RPPO-SNP) product offerings and state-specific administrative materials are available at UHCCommunityPlan.com > For Health Care Professionals > North Carolina.

To learn more about UnitedHealthcare Medicare Advantage plans offered in your area, please visit UHCMedicareSolutions.com and enter your ZIP code.

To learn more about Medicare Part D prescription drug coverage or to access related forms, please review the materials available on UHCMedicareSolutions.com under Our Plans > Medicare Advantage Plans > What Do I Need to Know? > Medicare Advantage Plan Information and Forms.


Reminder for Special Needs Plan Providers

UnitedHealthcare provides Special Needs Plan (SNP) care providers access to SNP beneficiaries' Health Risk Assessments (HRAs) and Individualized Care Plans (ICPs) in a variety of ways including mailing, faxing, uploading to the Provider Portal or placing Individualized Care Plans in the SNP beneficiary's physical and/or electronic chart.

Care providers should be reviewing the SNP beneficiary's Individualized Care Plans and participating with the SNP Interdisciplinary Care Team to coordinate the beneficiary's care. Special Needs Plan care providers can register online at UHCprovider.com to begin accessing and reviewing SNP beneficiary Individualized Care Plans via the Care Conductor Tool on Link.