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AARP Medicare Advantage from UHC CA-0005 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC CA-0005 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage from UHC CA-0005 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Fresno, Kings, and Madera Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC CA-0005 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage from UHC CA-0005 (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For AARP Medicare Advantage from UHC CA-0005 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $59.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $440.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AARP Medicare Advantage from UHC CA-0005 (HMO-POS) plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $440.00. During the initial coverage phase, you will pay a $12.00 copay for Tier 1 preferred generic drugs and 15% coinsurance for Tier 2 standard generic drugs at standard pharmacies. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs require 38% and 28% coinsurance respectively across standard pharmacies and mail-order options. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy can see their Part D premium reduced from $26.10 down to $14.10.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0005 (HMO-POS) plan offers comprehensive medical coverage with no deductibles and highly predictable out-of-pocket costs. Members benefit from no copay for primary care visits, telehealth, routine preventive care, and home health services. For specialized care, inpatient hospital stays require a daily copay of $455 for the first several days, while outpatient specialist visits and lab services feature low to no copays and no coinsurance. Routine dental cleanings, vision exams, and hearing tests are covered with no copay, though prescription hearing aids and lenses require varying copayments. High-cost needs like durable medical equipment, dialysis, and therapeutic radiology require a 20% coinsurance with no copay. Additionally, emergency room visits carry a $130 copay, while routine transportation, cardiac rehabilitation, and over-the-counter items are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS) with no coinsurance, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Covered acute stays require a $455 daily copay for days 1 to 6 and no copay for days 7 to 999, while psychiatric stays require a $455 daily copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS) with no coinsurance and copays that vary by service. You will pay a $0 to $455 copay for outpatient hospital services, a $455 daily copay for observation services, a $0 to $25 copay for substance abuse sessions, and no copay for ambulatory surgical center and blood services.
Partial Hospitalization See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization and a doctor referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS), with ground and air ambulance services requiring a $290 copay and no coinsurance. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers primary care and telehealth visits with no copay or coinsurance, while other services like specialist, therapy, and mental health visits have copays ranging from $0 to $25 and no coinsurance. Chiropractic benefits are partially covered, as routine chiropractic care is not covered by the plan.
Preventive Services See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers preventive services with no copays or coinsurance, including annual physical exams, fitness benefits, and kidney disease education. However, the benefit is only partially covered, as several sub-services—such as health education, weight management programs, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS) with no deductibles or coinsurance, featuring no copay for annual routine exams but excluding fitting evaluations and inner, outer, or over-the-ear prescription aids. Covered prescription hearing aids require a $199 to $1,249 copay and OTC hearing aids require a $199 to $829 copay, with no coinsurance.
Vision Services See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) partially covers vision services, offering routine eye exams, contact lenses, and eyeglass frames with no copay, coinsurance, or deductible. Eyeglass lenses are covered with a copay of $0 to $153 and no coinsurance, up to a $150 combined eyewear limit every two years, while upgrades and eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS), offering preventive care such as cleanings, exams, and X-rays with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance with no copay, while restorative, endodontic, periodontic, and orthodontic services are not covered.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers home infusion bundled services with prior authorization, offering chemotherapy, radiation, and other Part B drugs with no copay and no coinsurance to 20% coinsurance. Medicare Part B insulin drugs are also covered under this benefit, requiring a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers Dialysis Services with 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS), with durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes requiring a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for most of these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC CA-0005 (HMO-POS), requiring prior authorization and doctor referrals. Under this plan, members pay no copay for lab services, a $30 copay for outpatient X-rays, a $50 copay for diagnostic tests, a $0 to $260 copay for diagnostic radiology, and 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the AARP Medicare Advantage from UHC CA-0005 (HMO-POS) plan with no copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC CA-0005 (HMO-POS) plan. Since sub-services such as intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered, there is no copay or coinsurance coverage available for these therapies.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC CA-0005 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance for days 1 through 20, and a $218 daily copay with no coinsurance for days 21 through 100. This benefit is partially covered as additional days beyond the Medicare-covered limit are not covered, and prior authorization and a doctor referral are required.
Other Services See details
Other Services are covered under the AARP Medicare Advantage from UHC CA-0005 (HMO-POS) plan, meaning some services are covered, but acupuncture, over-the-counter (OTC) items, meal benefits, and dual eligible SNPs with highly integrated services are not covered.
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