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AARP Medicare Advantage from UHC CA-0011 (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-0011 (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-0011 (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-0011 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Stanislaus 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-0011 (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-0011 (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-0011 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.00. 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 $340.00 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-0011 (HMO-POS) plan has a $340 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, the copay is $12 at a standard pharmacy. For standard generic drugs, the copay is $47. Preferred brand drugs have a $100 copay, and non-preferred drugs have a 29% coinsurance.
Additional Benefits
The AARP Medicare Advantage from UHC CA-0011 (HMO-POS) plan offers a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a $375 copay for days 1-6, with no copay for days 7-90. Outpatient services often have no copay, and emergency services have a $140 copay. This plan includes coverage for primary care with no copay, along with hearing and vision services, and dental services with no copay for preventive care. Home health services, diagnostic services, and skilled nursing facilities are covered, but may require prior authorization and have cost-sharing requirements. The plan also offers coverage for ambulance services, outpatient substance abuse, and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered with a $375 copay for days 1-6 and no copay for days 7-90; additional days for Acute have no copay, while Non-Medicare-covered stays and upgrades for Acute and additional days for Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $375, observation services with a $375 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with copays ranging from $0 to $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under this plan and requires prior authorization and a doctor referral. There is a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the AARP Medicare Advantage from UHC CA-0011 (HMO-POS) plan, with prior authorization required for all ambulance services. Ground and air ambulance services each have a copay of $290, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by this plan. Emergency Services has a $140 copay and no coinsurance, Urgently Needed Services has a copay between $0 and $65 and no coinsurance, and Worldwide Emergency Services has a $0 copay and no coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
AARP Medicare Advantage from UHC CA-0011 (HMO-POS) covers primary care physician services with no copay, chiropractic services with a $15 copay (routine care not covered), and occupational therapy services with a copay between $0 and $15. Additionally, this plan covers physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services, all with varying copays.
Preventive Services See details
Preventive Services are covered, including an annual physical exam with no copay. Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit all have no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with no copay, but fitting/evaluation for hearing aids is not covered. Prescription hearing aids have a copay between $199 and $1249, depending on the type of hearing aid, and OTC hearing aids have a copay between $99 and $829.
Vision Services See details
The AARP Medicare Advantage from UHC CA-0011 (HMO-POS) plan covers vision services, including routine eye exams and eyewear. Eye exams and eyewear have no copay, while eyeglass lenses have a copay of $0 - $153. Contact lenses, eyeglass frames, and eyeglass lenses are covered, but eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. However, orthodontic services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the AARP Medicare Advantage from UHC CA-0011 (HMO-POS) plan, but require prior authorization and a doctor's referral. You are responsible for 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and authorization required, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests and Lab Services with no copay, as well as Diagnostic Radiological Services with a copay of at most $55.00, and Outpatient X-Ray Services with a $15.00 copay. Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC CA-0011 (HMO-POS) with no copay and no coinsurance, but require authorization and a referral. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but there is no information about the cost sharing for the services. However, intensive cardiac rehabilitation services, pulmonary rehabilitation services, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the AARP Medicare Advantage from UHC CA-0011 (HMO-POS) plan, but require prior authorization and a doctor's referral. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, while acupuncture, meal benefits, and several other services are not covered. This plan also offers OTC nicotine replacement therapy and Naloxone coverage.
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