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AARP Medicare Advantage from UHC CA-9P (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-9P (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-9P (HMO-POS) in 2025, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-9P (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in San Francisco 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-9P (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-9P (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-9P (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.00. 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 $3400.00 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-9P (HMO-POS) plan has an "Enhanced Alternative" drug benefit. The plan has a $340 deductible for prescription drugs. After the deductible, you will pay a copay for your prescriptions depending on the drug tier and pharmacy. For example, a standard pharmacy will have a $12 copay for preferred generic drugs, and a $100 copay for preferred brand drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The AARP Medicare Advantage from UHC CA-9P (HMO-POS) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays. Emergency, urgent, and worldwide emergency services have no copay. Preventative services, primary care, hearing, vision, and dental services are covered, with no or low copays for many services. This plan also covers ambulance services, partial hospitalization, and home health services, with some services requiring prior authorization. Diagnostic and radiological services, medical equipment, and dialysis services are covered with copays or coinsurance. Other benefits include coverage for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization and a doctor referral. For days 1-6, there is a $395 copay, and for days 7-90, there is no copay.
Outpatient Services See details
Outpatient Services are covered by the AARP Medicare Advantage from UHC CA-9P (HMO-POS) plan, including all outpatient hospital services with a copay between $0 and $395, observation services with a $395 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a copay between $0 and $25 for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for all outpatient services.
Partial Hospitalization See details
Partial Hospitalization is covered by the AARP Medicare Advantage from UHC CA-9P (HMO-POS) plan, but requires prior authorization and a doctor referral. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by AARP Medicare Advantage from UHC CA-9P (HMO-POS), including both ground and air ambulance services with a $290 copay, and 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. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $65; all services have no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care Physician Services are covered with no copay, while Chiropractic Services require a $10 copay, and Occupational Therapy Services have a copay between $0 and $10. Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $10. Mental Health Specialty Services, Podiatry Services, Psychiatric Services, and Opioid Treatment Program Services have varying copays depending on the service, while Additional Telehealth Benefits have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services, kidney disease education services, and other preventive services which all have a $0 minimum and maximum copay. Some services are not covered, including health education, in-home safety assessment, personal emergency response system, medical nutrition therapy, 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.
Hearing Services See details
Hearing exams are covered with no copay, while routine hearing exams are covered with no copay for one visit every year. Prescription hearing aids are covered with a copay between $199 and $1249 for two hearing aids every year, while OTC hearing aids have a copay between $99 and $829. Fitting/evaluation for hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay, but the plan does not cover eyeglasses (lenses and frames) or upgrades.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Medicare Dental Services have a 20% coinsurance, while restorative services and prosthodontics, fixed have a 0-50% coinsurance. Implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with a copay of $35 for Medicare Part B Insulin Drugs and a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs. Prior authorization is required for all services.
Dialysis Services See details
Dialysis Services are covered by AARP Medicare Advantage from UHC CA-9P (HMO-POS). This benefit requires prior authorization and a doctor's referral, with a coinsurance of 20%.
Medical Equipment See details
Medical equipment is covered, with a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies have no copay, and diabetic therapeutic shoes and inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization and a doctor referral required. Diagnostic Procedures/Tests have no copay, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $95, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the AARP Medicare Advantage from UHC CA-9P (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the associated sub-services, including 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 under the AARP Medicare Advantage from UHC CA-9P (HMO-POS) plan, but require prior authorization and a doctor 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 SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items with no copay, while acupuncture, meal benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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