UnitedHealthcare Dual Special Needs Plans Offer Medicare Medicaid Benefits

UnitedHealthcare Dual Complete ME-S1 Enrollment Details

Maine residents qualifying for both Medicare and Medicaid can begin reviewing the enrollment parameters for the 2027 UnitedHealthcare Dual Complete ME-S1 (PPO D-SNP) plan.

According to UnitedHealthcare, these Dual Special Needs plans are insured through UnitedHealthcare Insurance Company or its affiliated companies.

The plan operates as a Medicare Advantage organization that maintains a contract with both Medicare and the State Medicaid Program. Because these plans rely on specific agreements, enrollment for members is dependent on the plan’s contract renewal with Medicare.

For individuals with Extra Help, also known as a Low Income Subsidy, the Dual Special Needs plans feature a $0 premium. However, UnitedHealthcare notes that benefits, features, and specific devices may vary depending on the individual’s specific area and plan selection.

Potential enrollees should be aware that limitations, exclusions, or network restrictions may apply to coverage. The company also specifies that the pharmacy network, formulary, and provider network are subject to change at any time, though members will receive notice when such changes occur.

Managing Healthcare Access and Networks

UnitedHealthcare emphasizes that the choice of provider rests with the member. While the company provides information to assist in making informed decisions, such as physician credentials, this information does not constitute an endorsement of any specific healthcare professional’s suitability.

UnitedHealthcare Dual Special Needs Plans Offer Medicare Medicaid Benefits

The provider directory available through the application may not represent the full extent of the UnitedHealthcare network. Some specialties or specific providers might not be listed in the digital application even if they are part of the contracted network.

To ensure continuous care, UnitedHealthcare recommends that members call their physician's office directly to verify participation status and availability before scheduling an appointment. Members can also contact Customer Care using the toll-free number found on their UnitedHealthcare ID card to confirm if a provider is still accepting new members.

Out-of-network or non-contracted providers are not under any obligation to treat plan members, except in cases of emergency. For details regarding cost-sharing that applies to out-of-network services, members are encouraged to review their Evidence of Coverage.

Emergency Protocols and Support Services

This service is not an insurance program and can be discontinued at any time. It is not a substitute for professional provider care and cannot be used to diagnose problems or recommend treatment.

In an emergency, individuals should call 911 or go to the nearest emergency room immediately.

In the event of a disaster or emergency declaration by a Governor, the President, or a public health emergency announcement by the Secretary of Health and Human Services, additional support may become available. During such periods, the following adjustments may occur:

Part A, Part B, and supplemental Part C plan benefits may be provided at specified non-contracted facilities, provided Part A and Part B benefits are obtained at Medicare-certified facilities.
Requirements for gatekeeper referrals may be waived in full.
Plan-approved out-of-network cost-sharing amounts may be temporarily reduced to match network cost-sharing amounts.
The standard 30-day notification requirement for members may be waived, provided the changes benefit the member.

If the Centers for Medicare & Medicaid Services (CMS) does not provide an end date for a declared disaster or emergency, plans will return to normal operations 30 days after the initial declaration.

For those seeking official federal information regarding Medicaid, the primary resource is Medicaid.gov.

Medicare evaluates these plans annually using a 5-Star rating system, which was applied to the 2026 plan year. Paper copies of the network provider directory are available at no cost to members upon request via the customer service number on their ID card.

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