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AARP Medicare Advantage from UHC CA-0007 (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-0007 (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-0007 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Diego County. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that AARP Medicare Advantage from UHC CA-0007 (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-0007 (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-0007 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $48.00. 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 $255.00 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 $3800.00 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-0007 (HMO-POS) plan has a $255.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs at a standard pharmacy, the copay is $10.00. For preferred brand drugs, the copay is $100.00, and for non-preferred drugs, you will pay 30% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a copay of $175 for days 1-8, but no copay for the rest of the stay. Outpatient services have copays ranging from $0 to $175, and primary care visits have a copay of $0-$10. The plan includes coverage for emergency services with a $140 copay, and ambulance services with a $290 copay. Preventive services, hearing exams, vision exams, and many dental services are available with no copay. Additionally, the plan covers home health services, dialysis services, and skilled nursing facilities with no or low copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-8, you will pay a $175 copay, and days 9-90 have no copay; additional days for Inpatient Hospital-Acute have no copay.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $175, Observation Services with a $175 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and Outpatient Blood Services with no copay. Prior authorization and a doctor referral are required for these services.
Partial Hospitalization See details
Partial Hospitalization is covered under the AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan, with a $55 copay. Prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground and air ambulance services with a $290 copay, and transportation services to a plan-approved health-related location with no copay. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS). Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $30. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay.
Primary Care See details
The AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan covers primary care physician services with a copay of $0-$10, chiropractic services with no copay (routine care and other services), occupational therapy services with a copay of $0-$35, and physician specialist services with a copay of $0-$35. The plan also covers mental health specialty services with a copay that varies from $0-$25 for individual sessions and $15 for group sessions, other health care professional services with a copay of $0-$10, psychiatric services with a copay that varies from $0-$25 for individual sessions and $15 for group sessions, and physical therapy and speech-language pathology services with a copay of $0-$35. Additionally, additional telehealth benefits are covered with no copay, and opioid treatment program services are covered with no copay. Podiatry services are not covered.
Preventive Services See details
Preventive services include no copay for a yearly physical exam and other services, like glaucoma screening, diabetes self-management training, and barium enemas. Other services such as health education, in-home safety assessments, and more are not covered.
Hearing Services See details
Hearing exams are covered with no copay. Prescription hearing aids are covered with a copay between $199 and $1249 depending on the type of hearing aid, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and contact lenses. Eye exams and eyewear have no copay, while contact lenses have no copay. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan covers dental services, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, and other preventive services with no copay. Medicare dental services have a 20% coinsurance, and restorative services, prosthodontics (removable and fixed), and maxillofacial prosthetics have a 0-50% coinsurance. The plan does not cover implant services or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 15%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 15%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan. There is no copay for dialysis services.
Medical Equipment See details
Medical Equipment includes Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, all of which have a 15% coinsurance for some services. Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 15% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Lab Services have no copay, while Diagnostic Procedures/Tests have a $0 copay. Outpatient X-rays have a $25 copay, Diagnostic Radiological Services have a maximum copay of $100, and Therapeutic Radiological Services have a $60 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization and a doctor referral are required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan, requiring prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $203 per day.
Other Services See details
The AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan covers acupuncture and over-the-counter (OTC) items with no copay. The plan covers a meal benefit with no copay, but prior authorization is required. Other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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