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AARP Medicare Advantage from UHC CA-004P (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-004P (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-004P (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-004P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Los Angeles 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-004P (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-004P (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-004P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $800.00 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-004P (HMO-POS) plan features an annual prescription drug deductible of $355.00. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies. For other drug tiers, the plan charges a 16% coinsurance for standard generics, a 40% coinsurance for preferred brands, and a 29% coinsurance for non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the Extra Help low-income subsidy can see their Part D premium and LIS cost-sharing reduced to $0.00.
Additional Benefits
The AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan offers comprehensive coverage with no copay and no coinsurance for many essential services, including inpatient hospital stays, primary care, specialist visits, and routine outpatient services. Emergency care is available with a $150 copay, which is waived if you are admitted, while worldwide emergency services and urgent care feature no copay. Additionally, diagnostic labs, X-rays, and preventative screenings are covered with no copays or coinsurance. For specialized care, the plan provides routine dental, vision, and hearing exams with no copay or coinsurance, though comprehensive dental requires a 50% coinsurance and hearing aids involve copays up to $1,249. Durable medical equipment, diabetic shoes, and dialysis services require a 20% coinsurance with no copay, while diabetic supplies are fully covered with no copay. Transportation benefits are also included, offering up to 24 one-way trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), featuring Medicare-covered acute and psychiatric stays with no copay and no coinsurance. However, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) with no copay and no coinsurance for outpatient hospital, observation, ambulatory surgical center, and blood services. Outpatient substance abuse services are also covered with no coinsurance, requiring a $0 to $25 copay for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
AARP Medicare Advantage from UHC CA-004P (HMO-POS) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization and a doctor referral are required to access this covered service.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC CA-004P (HMO-POS) covers ground and air ambulance services with a $200 copay and no coinsurance. 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-004P (HMO-POS) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay of $0 to $20 and no coinsurance, while worldwide emergency coverage, urgent coverage, and emergency transportation are all covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) with no copay and no coinsurance for primary care provider, specialist, physical therapy, and podiatry visits. Mental health and psychiatric services also feature no coinsurance, with copays ranging from $0 to $25 for individual sessions and a $15 copay for group sessions.
Preventive Services See details
Preventive services are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) with no copay and no coinsurance, including annual physical exams, kidney disease education, and glaucoma screenings. However, the plan's additional preventive services are only partially covered, excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
AARP Medicare Advantage from UHC CA-004P (HMO-POS) provides partially covered hearing services, featuring no copay or coinsurance for one annual routine hearing exam. Prescription hearing aids (all types) and OTC hearing aids are covered with no coinsurance and copays ranging from $199 to $1,249 and $199 to $829 respectively. However, fitting and evaluation for hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), as upgrades and packaged eyeglasses (lenses and frames) are not covered. Routine eye exams, contact lenses, and eyeglass frames are offered with no copay and no coinsurance, while eyeglass lenses have a copay of $0 to $153 and no coinsurance, subject to a $200 combined eyewear limit every two years.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), with implant services and orthodontics not covered. Preventive and diagnostic services are available with no copay and no coinsurance, while covered comprehensive services require a 50% coinsurance and no copay, up to a $1,000 annual maximum.
Home Infusion bundled Services See details
AARP Medicare Advantage from UHC CA-004P (HMO-POS) covers home infusion bundled services with prior authorization, though Part D home infusion drugs are not covered as a mandatory supplemental benefit. Medicare Part B chemotherapy, radiation, and other drugs require no copay and range from no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
AARP Medicare Advantage from UHC CA-004P (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization and a doctor referral are required to receive these covered services.
Medical Equipment See details
Medical equipment benefits are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), with durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes requiring a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, though prior authorization is required for most of these equipment services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) with no copay and no coinsurance for lab services, diagnostic tests, outpatient X-rays, and diagnostic radiology. Therapeutic radiological services are covered with a 20% coinsurance and no copay, with all services requiring a doctor referral and prior authorization.
Home Health Services See details
Home Health Services are covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) with no copay and no coinsurance. Prior authorization and a doctor referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically offered by AARP Medicare Advantage from UHC CA-004P (HMO-POS) and some services are covered, but in practice, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. There is no copay or coinsurance for these services, which require prior authorization and a doctor referral.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), requiring prior authorization and a doctor referral, though additional days beyond the Medicare-covered limit are not covered. There is no copay and no coinsurance for days 1 through 20, followed by a $100 daily copay and no coinsurance for days 21 through 100.
Other Services See details
Other Services are partially covered by AARP Medicare Advantage from UHC CA-004P (HMO-POS), which provides acupuncture and over-the-counter (OTC) items with no copay and no coinsurance. Meal benefits and dual eligible SNPs with highly integrated services are not covered under this plan.
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