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AARP Medicare Advantage from UHC CA-9 (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-9 (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-9 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC CA-9 (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 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC CA-9 (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-9 (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-9 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $69.00. 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 $4900.00 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-9 (HMO-POS) plan offers an Enhanced Alternative prescription drug benefit with an annual drug deductible of $440.00. For beneficiaries who qualify for the low-income subsidy, also known as Extra Help, the Part D premium is reduced from $69.00 to $57.00. After meeting the deductible, you will enter the initial coverage phase until your total drug costs reach $2,100.00, after which the catastrophic coverage phase begins and you have no copay for covered Part D drugs. During the initial coverage phase, a 30-day supply of Tier 1 preferred generic drugs at a standard pharmacy requires a $12.00 copay, while Tier 2 standard generics require a 16% coinsurance. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs carry a 37% and 28% coinsurance respectively, which apply to standard retail pharmacy purchases as well as preferred and standard mail-order options.
Additional Benefits
The AARP Medicare Advantage from UHC CA-9 (HMO-POS) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, telehealth, home health services, and routine preventive care. For specialized care, specialist visits and outpatient sessions feature low copays ranging from no copay up to $25, while emergency room visits require a $130 copay. Inpatient hospital stays require a $550 daily copay for the first few days, after which there is no copay for subsequent covered days. Routine dental, vision, and hearing exams are also available with no copay, though advanced services like hearing aids and comprehensive dental care require copays or up to 50% coinsurance. Essential medical equipment, prosthetics, and dialysis services require a 20% coinsurance with no copay, while diabetic supplies are fully covered with no copay. Additionally, covered Medicare Part B insulin drugs are capped at a $35 copay with coinsurance up to 20%.
Inpatient Hospital See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $550 daily copay for days 1 to 5 of acute care and days 1 to 4 of psychiatric care, with no copay for subsequent covered days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $550 copay for outpatient hospital services and a $550 daily copay for observation services. Outpatient substance abuse sessions require a $0 to $25 copay, while ambulatory surgical center and blood services are covered with no copay.
Partial Hospitalization See details
Partial hospitalization is covered by the AARP Medicare Advantage from UHC CA-9 (HMO-POS) plan with a $55.00 copay and no coinsurance. Prior authorization and a doctor referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by AARP Medicare Advantage from UHC CA-9 (HMO-POS). Ground and air ambulance services require a $290 copay and no coinsurance, while health-related transportation services are not covered.
Emergency Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) covers emergency services with a $130 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 $50 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance.
Primary Care See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) covers primary care visits, telehealth, and opioid treatment with no copay and no coinsurance. Specialist visits, mental health, podiatry, and physical or occupational therapy have copays ranging from $0 to $25 and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, as routine chiropractic care is not covered.
Preventive Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) partially covers preventive services, providing benefits like annual physicals, fitness programs, and select screenings with no copay and no coinsurance. However, sub-services such as health education, weight management programs, alternative therapies, and caregiver support are not covered.
Hearing Services See details
Hearing services are partially covered by the AARP Medicare Advantage from UHC CA-9 (HMO-POS) plan, featuring routine hearing exams with no copay or coinsurance, though fitting and evaluation exams are not covered. Prescription and OTC hearing aids are covered up to two per year with copays ranging from $199 to $1,249 and no coinsurance, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) provides partially covered vision services, as eyeglasses (lenses and frames) and upgrades are not covered. Routine eye exams, contact lenses, and eyeglass frames are available with no copay or coinsurance, while eyeglass lenses have a copay of $0 to $153 and no coinsurance under a $150 combined limit every two years.
Dental Services See details
Dental services are partially covered under AARP Medicare Advantage from UHC CA-9 (HMO-POS), offering preventive care like cleanings and exams with no copays or coinsurance up to a $1,000 yearly maximum. Medicare-covered dental services require a 20% coinsurance and no copay, while covered comprehensive services require a 50% coinsurance and no copay; implant services and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by AARP Medicare Advantage from UHC CA-9 (HMO-POS), subject to prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by AARP Medicare Advantage from UHC CA-9 (HMO-POS) with a 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-9 (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, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) covers diagnostic and radiological services, requiring doctor referrals and prior authorization for all services. Members enjoy no copay for diagnostic tests and lab services, while outpatient X-rays require a $30 copay, diagnostic radiological services range from a $0 to $260 copay, and therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) covers Home Health Services with no copay and no coinsurance. Prior authorization and a doctor referral are required to access these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the AARP Medicare Advantage from UHC CA-9 (HMO-POS) plan. This non-coverage applies to all sub-services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by AARP Medicare Advantage from UHC CA-9 (HMO-POS), featuring no copay for days 1-20, a $218 daily copay for days 21-100, and no coinsurance. Prior authorization and a doctor referral are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC CA-9 (HMO-POS) partially covers Other Services, providing over-the-counter (OTC) items with no copay and no coinsurance. Sub-services including acupuncture, meal benefits, and dual eligible SNPs with highly integrated services are not covered.
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