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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 2025, 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 3 out of 5 stars in 2025.
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 $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 $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 has a $255 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, there is no copay. Standard generic drugs have a $35 copay, while preferred brand drugs have a $100 copay. Non-preferred drugs have a 30% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan offers a variety of benefits with varying costs. Many services, including inpatient hospital stays, outpatient services, primary care, preventive services, vision, dental, and home health services, have no copay. This plan also covers emergency services, hearing, and medical equipment. Some services have copays, such as partial hospitalization, ambulance services, and certain mental health services. Other services, like dialysis, home infusion, and certain medical equipment, have coinsurance costs. Overall, this plan provides a broad range of coverage with both no-cost and cost-sharing options.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Inpatient Hospital-Acute has no copay for a Medicare-covered stay, and no copay for days 91-999, while Non-Medicare-covered Stay and Upgrades are not covered. Inpatient Hospital Psychiatric has no copay for a Medicare-covered stay, and Additional Days and Non-Medicare-covered Stay are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services, are covered by the AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan. Outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services have no copay, while individual outpatient substance abuse sessions have a copay between $0 and $25, and group sessions have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a $55 copay, and requires prior authorization and a doctor referral.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground and air ambulance services, each with a $150 copay, and transportation services to plan-approved health-related locations with no copay for up to 24 one-way trips per year. 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. For Emergency Services, the copay is $125, and there is no coinsurance. Urgently Needed Services have a copay between $0 and $20, with no coinsurance. Worldwide Emergency Coverage, Urgent Coverage, and Emergency Transportation have no copay and no coinsurance.
Primary Care See details
The AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan offers primary care physician services, chiropractic services, occupational therapy services, 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. Primary care, chiropractic, physician specialist, physical therapy and speech-language pathology services, and additional telehealth benefits have no copay. Mental health specialty services have a copay between $0 and $25, and psychiatric services have a copay between $0 and $25. Podiatry services have a copay of $0, but routine foot care is limited to 2 visits per year.
Preventive Services See details
Preventive Services include annual physical exams with no copay, and additional preventive services, including fitness benefits, and home and bathroom safety devices and modifications, with no copay. Kidney disease education services, and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit are covered with no copay. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, 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 Services include hearing exams with no copay, routine hearing exams with no copay for 1 visit per year, and OTC hearing aids with a copay of $99-$829. Prescription hearing aids are covered with a copay of $199-$1249 for 2 hearing aids every year, while 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 and eyewear, with no copay for eye exams, contact lenses, and eyeglass frames. Eyeglass lenses have a copay between $0 and $153, and a maximum plan benefit of $300 for all eyewear every two years. Eyeglasses (lenses and frames) and upgrades are not covered.
Dental Services See details
The AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan covers dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay, but has a $1,500 maximum benefit per year. Restorative services, adjunctive general services, endodontics, periodontics, maxillofacial prosthetics, and oral and maxillofacial surgery are covered with no copay. However, implant services and orthodontics are not covered, and prosthodontics, removable and fixed have a coinsurance between 0% and 50%.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment includes coverage for Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies also have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures, lab services, and radiological services. Diagnostic procedures and lab services have no copay, while therapeutic radiological services have a 20% coinsurance and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC CA-004P (HMO-POS) plan with no copay and no coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Authorization and referral are required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the sub-services of 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 with prior authorization and a doctor's referral. For days 1-20, there is no copay, and for days 21-100, the copay is $100.
Other Services See details
Other Services includes acupuncture and over-the-counter (OTC) items. Acupuncture has no copay and is limited to 20 treatments per year. OTC items also have no copay and include nicotine replacement therapy and Naloxone coverage, but does not cover all drugs on the CMS OTC list. Some other services are not covered.
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