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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 2026, 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 4 out of 5 stars in 2026.
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 $53.00. 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 $355.00 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 offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $355.00. Under the initial coverage phase, you will pay a $10.00 copay for Tier 1 preferred generics at standard pharmacies, and an 18% coinsurance for Tier 2 standard generics. Tier 3 preferred brands require a 35% coinsurance, while Tier 4 non-preferred drugs have a 29% coinsurance for standard pharmacy and mail order services. After your yearly out-of-pocket drug costs reach $2,100.00, you transition to the catastrophic coverage phase where you pay nothing for covered Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy can see their Part D premium reduced from $53.00 down to $41.00.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan offers comprehensive medical coverage designed to keep your out-of-pocket costs predictable. For inpatient hospital stays, members pay a $175 daily copay for days 1 through 8 and no copay for subsequent days, while emergency room visits carry a $150 copay. Many routine services, including primary care visits, diagnostic lab tests, and home health services, are available with no copay, helping you manage your health affordably. This plan also features robust supplemental benefits, including annual routine eye exams, preventive dental care, and acupuncture with no copay. Additionally, members benefit from a $300 eyewear allowance every two years and up to 24 one-way transportation trips per year to plan-approved locations at no cost. Prescription hearing aids, comprehensive dental care, and durable medical equipment are also covered, though they may require specific copays or coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) partially covers inpatient acute and psychiatric hospital stays with a $175 daily copay for days 1 through 8, no copay for days 9 and beyond, and no coinsurance. Prior authorization and doctor referrals are required, and exclusions apply to upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of up to $175, while outpatient substance abuse sessions range from no copay to a $25 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under AARP Medicare Advantage from UHC CA-0007 (HMO-POS) with a $55.00 copay and no coinsurance. Receiving this covered service requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS), featuring a $260 copay and no coinsurance for ground and air ambulance rides. Transportation services are partially covered with no copay or coinsurance for up to 24 one-way trips per year to plan-approved locations, while transportation to any health-related location is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $0 to $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay.
Primary Care See details
Primary care benefits are partially covered under the AARP Medicare Advantage from UHC CA-0007 (HMO-POS) plan, with podiatry services not covered. Covered services feature no coinsurance, with copays ranging from no copay (including routine chiropractic and telehealth) up to $35 depending on the service.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS) with no copay or coinsurance for annual physical exams, kidney disease education, fitness benefits, and home safety devices. However, several supplemental benefits are not covered, including health education, personal emergency response systems, weight management, alternative therapies, therapeutic massage, and caregiver support.
Hearing Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) partially covers hearing services with no deductible, offering one routine hearing exam annually with no copay or coinsurance, while excluding hearing aid fittings and evaluations. Prescription and OTC hearing aids are covered with no coinsurance and copays ranging from $199 to $1,249, although inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS), including annual routine eye exams with no copay and no coinsurance. Eyewear is partially covered up to a $300 allowance every two years with no coinsurance, featuring no copay for contact lenses and frames, and a $0 to $153 copay for lenses. Upgrades and packaged eyeglasses (lenses and frames) are not covered.
Dental Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) partially covers dental services, offering preventive care like cleanings and exams with no copay, and comprehensive services at a 50% coinsurance up to a $1,000 annual limit. Medicare-covered dental services require a 20% coinsurance, but implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS) subject to prior authorization. Covered Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 15% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 15% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS) with no copay, though coinsurance information is not specified. Prior authorization and a doctor referral are required to receive this coverage.
Medical Equipment See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) covers durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes with a 15% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS) with prior authorization and doctor referrals required. There is no copay or coinsurance for diagnostic tests and lab services, while outpatient x-rays require a $25 copay, diagnostic radiology requires a $0 to $100 copay, and therapeutic radiology has a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS) with no copay and no coinsurance. Members will need to obtain a doctor referral and prior authorization to receive these covered services.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) indicates some services are covered, but Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Since these services are not covered, there is no copay or coinsurance benefit available for them.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by AARP Medicare Advantage from UHC CA-0007 (HMO-POS), requiring a doctor referral and prior authorization. Covered services feature no coinsurance, with no copay for days 1 to 20 and a $218 daily copay for days 21 to 100; however, additional days beyond Medicare-covered SNF care are not covered.
Other Services See details
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) partially covers Other Services, offering acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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