A non-government entity
AARP Medicare Advantage from UHC CA-005P (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-005P (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-005P (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-005P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Orange 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-005P (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-005P (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-005P (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:
Sign up for AARP Medicare Advantage from UHC CA-005P (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The AARP Medicare Advantage from UHC CA-005P (HMO-POS) plan features an enhanced alternative drug benefit with a 355 dollar annual prescription drug deductible. After meeting this deductible, you will enter the initial coverage phase where you pay no copay for Tier 1 preferred generic drugs at a standard pharmacy. For other tiers, standard pharmacy costs include a 16 percent coinsurance for Tier 2 standard generics, 41 percent coinsurance for Tier 3 preferred brands, and 29 percent coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach 2,100 dollars, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescription drugs. Additionally, if you qualify for the Low-Income Subsidy, also known as Extra Help, your Part D cost-sharing is reduced to zero dollars. To ensure your specific prescriptions are covered, we recommend reviewing the plan's formulary.
Additional Benefits
The AARP Medicare Advantage from UHC CA-005P (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, primary care, specialist visits, outpatient services, and home health care. Diagnostic laboratory tests and preventive services are also covered with no copay, while emergency care requires a $150 copay and ambulance services carry a $200 copay. Additionally, the plan provides up to 24 one-way transportation trips to plan-approved locations per year with no copay and no coinsurance. For routine care, members enjoy no copay and no coinsurance for annual vision, hearing, and preventive dental exams, as well as acupuncture treatments. Specialized benefits like hearing aids and vision eyewear are covered with varying copays up to plan limits, while comprehensive dental services require a 50% coinsurance. Durable medical equipment, diabetic therapeutic shoes, and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) partially covers inpatient hospital benefits with no copay and no coinsurance for Medicare-covered acute and psychiatric stays. Upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Outpatient services are covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS) with no coinsurance, featuring no copays for outpatient hospital, observation, ambulatory surgical center, and blood services. Outpatient substance abuse services are also covered with no coinsurance, carrying a $15 copay for group sessions and a copay of $0 to $25 for individual sessions.
Partial Hospitalization See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) covers partial hospitalization benefits with a $55.00 copay and no coinsurance. Prior authorization and a doctor referral are required to receive these covered services.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) covers ground and air ambulance services with a $200 copay and no coinsurance. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-005P (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 copay ranging from no copay to $20 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay.
Primary Care See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) covers primary care, specialist visits, physical therapy, and podiatry with no copay and no coinsurance. Mental health and psychiatric services feature no coinsurance, with individual sessions ranging from no copay to a $25 copay, and group sessions requiring a $15 copay.
Preventive Services See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and select screenings, with no copays or coinsurance. Additional preventive benefits are partially covered, offering fitness programs and home safety devices with no copay or coinsurance, while sub-services like health education, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), offering one annual routine hearing exam with no copay and no coinsurance. Prescription hearing aids (all types) and OTC hearing aids are covered up to two devices per year with copays ranging from $199 to $1,249 and $199 to $829 respectively, with no coinsurance, though fitting/evaluation exams and specific inner ear, outer ear, and over-the-ear prescription aid types are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), which provides routine eye exams with no copay and no coinsurance. Covered eyewear includes contact lenses and eyeglass frames with no copay, and eyeglass lenses with a $0 to $153 copay, all featuring no coinsurance up to a $200 combined limit every two years. Upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), with implant services and orthodontics excluded from coverage. Covered preventive and diagnostic services feature 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-005P (HMO-POS) covers Home Infusion bundled Services with prior authorization required. Chemotherapy, radiation, and other Part B drugs feature no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS) with 20% coinsurance and no copay. Prior authorization and a doctor referral are required to receive these services.
Medical Equipment See details
Medical equipment is covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), with durable medical equipment, prosthetic devices, 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 these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), with prior authorization and doctor referrals required. There is no copay and no coinsurance for diagnostic procedures, lab services, diagnostic radiology, and outpatient X-rays, while therapeutic radiological services require a 20% coinsurance and a copay.
Home Health Services See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) covers Home Health Services with no copay and no coinsurance. To access these services, a doctor referral and prior authorization are required.
Cardiac Rehabilitation Services See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) indicates that some services are covered for Cardiac Rehabilitation, but in practice, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Because these services are not covered, there are no copays or coinsurance costs for members.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by AARP Medicare Advantage from UHC CA-005P (HMO-POS), requiring prior authorization and a doctor referral. There is no copay and no coinsurance for days 1 to 20, and a $100 daily copay with no coinsurance for days 21 to 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC CA-005P (HMO-POS) partially covers other services, offering acupuncture and over-the-counter (OTC) items with no copay and no coinsurance, while meal benefits and dual eligible SNPs are not covered. Covered acupuncture is limited to 20 treatments per year, and the OTC benefit includes select items such as nicotine replacement therapy and naloxone.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved