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AARP Medicare Advantage from UHC CA-7 (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-7 (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-7 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-7 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Alameda 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-7 (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-7 (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-7 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $70.00. 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 $440.00 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 $5900.00 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-7 (HMO-POS) plan offers an Enhanced Alternative drug benefit with an annual prescription drug deductible of $440.00. In the initial coverage phase, you will pay a $12.00 copay for Tier 1 preferred generic drugs at standard pharmacies. For other tiers at standard pharmacies, you will pay a 15% coinsurance for Tier 2 standard generics, 41% coinsurance for Tier 3 preferred brands, and 28% coinsurance for Tier 4 non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescription drugs. Additionally, if you qualify for the full low-income subsidy, your Part D premium is reduced to $55.30.
Additional Benefits
The AARP Medicare Advantage from UHC CA-7 (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a $550 copay per day for days 1 through 4, followed by no copay for days 5 through 90. Emergency room visits carry a $130 copay, while outpatient hospital services range from no copay to a $550 copay depending on the service. Routine dental, vision, and hearing exams are covered with no copay, though more advanced services like hearing aids require copays ranging from $199 to $1,249. Diagnostic lab work and diabetic supplies are available with no copay, whereas durable medical equipment and dialysis services require a 20% coinsurance. Additionally, the plan covers over-the-counter items with no copay, helping members save on everyday health essentials.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS), with a $550 copay for days 1-4, no copay for days 5-90, and no coinsurance. Unlimited additional days for acute care are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of no copay to $550, observation services require a $550 daily copay, and outpatient substance abuse sessions range from no copay to a $25 copay.
Partial Hospitalization See details
Partial hospitalization is covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS) with a $55 copay and no coinsurance. This benefit requires a doctor referral and prior authorization.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay to $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are fully covered with no copay and no coinsurance.
Primary Care See details
Primary Care benefits are covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS) with no coinsurance, featuring no copay for primary care visits, telehealth, and opioid treatment. Other covered services, including specialists, therapies, and mental health services, require copays ranging from $0 to $45, though chiropractic services are only partially covered as routine chiropractic care is not covered.
Preventive Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay or coinsurance. However, the plan only partially covers additional preventive services, excluding options such as health education, personal emergency response systems, weight management programs, and in-home support services.
Hearing Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) provides partial coverage for hearing services, including one routine hearing exam annually with no copay or coinsurance, though fitting and evaluation exams are not covered. The plan also covers up to two prescription or OTC hearing aids per year with no coinsurance and copays ranging from $199 to $1,249, though specific inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS), featuring routine eye exams with no copay or coinsurance. Covered eyewear includes contact lenses and frames with no copay or coinsurance, and eyeglass lenses with a $0 to $153 copay and no coinsurance up to a $150 limit every two years, while upgrades and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Dental services are partially covered under the AARP Medicare Advantage from UHC CA-7 (HMO-POS) plan, offering preventive care like cleanings, exams, and x-rays with no copay and no coinsurance, and Medicare-covered dental services for a 20% coinsurance and no copay. However, orthodontic, restorative, endodontic, periodontic, prosthodontic, implant, and oral surgery services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS) with prior authorization, requiring no copay and no coinsurance to 20% coinsurance for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are covered under this benefit with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC CA-7 (HMO-POS) 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-7 (HMO-POS), with durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes requiring a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for these medical equipment services.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers diagnostic procedures and lab services with no copays or coinsurance, and outpatient X-rays with a $30 copay and no coinsurance. Diagnostic radiological services have a copay ranging from $0 to $260 with no coinsurance, while therapeutic radiological services require a 20% coinsurance and no copay.
Home Health Services See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization and a doctor referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC CA-7 (HMO-POS) plan. This exclusion applies to all sub-services, including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC CA-7 (HMO-POS) partially covers Skilled Nursing Facility (SNF) services, which require prior authorization and a doctor referral. Stays feature no copay or coinsurance for days 1 through 20 and a $218 daily copay with no coinsurance for days 21 through 100, but additional days beyond Medicare-covered services are not covered.
Other Services See details
Other Services are partially covered under the AARP Medicare Advantage from UHC CA-7 (HMO-POS) plan, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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